Rosy Kumar: Hospital haul-up

CAVEAT EMPTOR

Hospitals must not escape responsibility by passing their liability on to doctors, says Rosy Kumar

INVARIABLY, IN cases of medical negligence, hospitals and clinics take the plea that any deficiency in treatment cannot be attributed to them as it is the doctor who treated the patient, and therefore should alone be responsible.

Courts have given divergent verdicts, holding the hospitals liable in some cases, and not responsible in others on the grounds that they have no control over consulting doctors who are called upon to attend the patients admitted in the hospitals.

The above question has now been settled by the Supreme Court of India in a recent judgement handed down on October 12, 2004.

A K Garg, an electrical engineer from Rishikesh, was admitted in the National Heart Institute, New Delhi, for treatment. He was admitted for angiography on July 4, 1994 and Rs 14,000 was deposited for his treatment.

He was discharged the next day, and again admitted on August 2 and remained in the Institute till August 9, 1994. On August 3 he was operated upon and brought to the Intensive Care Unit. Yet one more operation was done by the treating doctor, Dr O P Yadav.

Eight bottles of blood were transfused into Garg's body, and due to wrong transfusion or extra transfusion, he developed septicaemia, as a result of which one leg had to be amputated; his kidneys stopped functioning and he was put on dialysis. On August 9, 1994 Garg was declared dead.

A complaint was filed by the deceased's wife, mother and children before the National Consumer Disputes Redressal Commission claiming a compensation of Rs 45 lakh.

When the matter came up for hearing the Institute pleaded that the patient was under the treatment of Dr O P Yadav and as he had not been implicated the case should be dismissed. The National Commission accordingly dismissed the complaint. An appeal was filed before the Supreme Court.

In its detailed judgement in the matter of Smt Savita Garg vs The Director, National Heart Institute the Supreme Court of India has held that the above approach of the National Commission is erroneous and the hospitals which admit the patients for treatment can in no case be exonerated on the plea that it is the attending doctor who alone should be hauled up and not the hospital.

It is well known that for better treatment and in complicated cases the patients approach renowned hospitals or specialised clinics. These private hospitals have a panel of specialised doctors who choose who will attend the patient.

Noticing this situation, the Supreme Court observed that "it is the common experience that when a patient goes to a private clinic, he goes by the reputation of the clinic and with the hope that proper care will be taken by the hospital authorities.

It is not possible for the patient to know which doctor will treat him. It is the responsibility of the clinics to provide best of the services when they charge for these services. In case it is found that services rendered by the clinic or hospital, as the case may be, are not up to mark... they are bound to reimburse them."

While the above case has been remanded back to the National Commission, the Supreme Court has gone to the extent of laying down the proposition of law to be followed in all such cases relying on the precedent of Spring Meadows Hospital vs Harjot Ahluwalia.

The court observed that "once an allegation is made that the patient was admitted in a particular hospital and evidence is produced to satisfy that he died of lack of proper care, then the burden lies on the hospital to justify that there was no negligence.

If they fail to discharge their duties through their doctors being employed on job or contract basis, it is the hospital which has to justify."

In light of the above pronouncement, it would be futile for hospitals to take the frivolous plea of passing on the liability for the mistreatment of the patients: henceforward hospitals will have to own up to their responsibility.