Case title:
M/S. Spring Meadows Hospital & Anr V. Harjol Ahluwalia Through, K.S. Ahluwalia & Anr
Date of Order:
25/03/1998
Bench:
Hon’ble Justice S. Saghir Ahmad & Hon’ble Justice G.B. Pattanaik.
Parties:
- PETITIONER: M/S. SPRING MEADOWS HOSPITAL & ANR
- RESPONDENT: HARJOL AHLUWALIA THROUGH, K.S. AHLUWALIA & ANR
IMPORTANT PROVISIONS:
-
Consumer Protection Act, 1986:
- Section 2(1) (d): Covers a wide range under the ambit of the word Consumer in it. The consumer is not only that person who hired the service but it also covers all those persons who got benefitted from the service which they get.
- Section 14(d): The commission has the right and power vested to hear the plea and award the compensation.
- Legal doctrine of “Res ipsa loquitur” – “Things speaks for itself”
OVERVIEW:
- According to the petition, the minor was taken to M/s. Spring Meadows Hospital on December 24, 1993, because his prior admission had failed to improve his health. After assessing the patient, the senior consultant determined that he had typhoid and ordered medications for therapy.
- On one such occasion, on December 30, 1993, a hospital nurse named Miss Bina Matthew gave the patient's father instructions to obtain an injection called "In Lariago" that was meant to be given to the patient intravenously. Once the nurse gave the patient the injection, the patient immediately fell ill, and a resident doctor, Dr. Dhananjay, was called for assistance.
- The patient was examined by the doctor, who diagnosed a cardiac arrest and attempted to physically pump the patient's chest to bring him back to life. After that, a manual respirator was used to keep the patient alive. The minor patient was put on a manual ventilator and received the required blood transfusion, but showed no indications of recovery.
- The medical staff then advised the patient's parents to transfer to a facility with an ICU and an auto-respirator. After being taken to AIIMS, the patient was examined by the medical staff, who determined that the patient was in critical condition and would only survive in a vegetative state because the damage to his brain was permanent and there was no possibility for the injured areas to be restored.
- The patient was re-admitted when the M/S Meadows Hospital offered to do so in order to take all necessary steps to stabilize his condition. The patient suffered irreparable harm, and the complainant claimed that the patient was only able to survive in a vegetative condition as a result of medical negligence.
- Hence, a compensation claim for Rs. 28 lakhs was made. The Commission came to the judgment that the kid had experienced cardiac arrest as a result of receiving a large dose of Lariago intravenously, and the hospital administration had engaged in medical negligence.
- As a result, the Commission granted the minor patient a compensation amount of Rs. 12.5 lakhs. Court also gave the parents of the minor child Rs. 5 lakhs as compensation for the emotional agony they had to undergo because their only son was still alive in a vegetative state and required lifetime care.
- While the case was entirely covered by the indemnification provision, the Commission additionally held the insurance company liable to indemnify the sum as per the terms of the policy on account of the hospital's obligation.
- The order issued by the National Consumer Disputes Redressal Commission, New Delhi, on June 16, 1997, led to the following appeals to the Supreme Court. The Hospital and the Insurance Company are the appellants in the two appeals.
ISSUES RAISED:
1. Can the parents of the minor child who was admitted to the hospital for treatment be considered consumers and make a claim for compensation under the terms of the Consumer Protection Act?
2. In light of the commission's authority granted by Section 14 of the Act, is it appropriate for it to grant the parents compensation for their mental suffering?
3. Even if the child and the child's parents fit the definition of "consumer" under Section 2(1)(d) of the Act, can compensation be given to both consumers or only to the recipient of the services provided? In this case, the child who was admitted to the hospital would be the beneficiary of the services.
ARGUMENTS ADVANCED BY THE APPELLANT:
- The learned counsel then argued that under Section 12 (1) (a) of the Consumer Protection Act, the consumer to whom services have been provided may make a complaint; in the case at hand, the minor patient becomes the consumer, and as a result, no compensation can be granted in favour of the consumer's parents.
- According to Section 14(1)(d) of the Act, the Commission is authorized to pay the amount in question as compensation to the consumer for any loss or damage incurred by that consumer. However, because the consumer in this case was a minor child, the Commission lacked the authority to grant parents compensation for the mental agony they have endured.
- The insurer's counsel argued that the hospital is not entitled to indemnification from the insurer since the hospital used incompetent personnel to treat patients, and that the Commission's order requiring the insurer to indemnify the insured is "unsustainable in law."
JUDGEMENT ANALYSIS:
- In response to the question of whether the parents of the minor child fall under the definition of "consumer," the court stated that under clause (ii) of Section 2 (1)(d) of the Act, a "consumer" "would include not only the person who hires the services but also the beneficiary of such services which beneficiary is other than the person who hires the services."
- In light of this, the minor kid's parents and the minor would both qualify as "consumers" for the purposes of Section 2(1)(d) of the Act and be eligible to make a claim for damages in the current situation.
- When asked whether the Commission could compensate the parents of a minor child, the court rejected the petitioner's argument and said that the parents of the child who had used the hospital's services and the child was the beneficiary of those services fell within the meaning of Section 2(1)(d) of the Act.
- As a result, the Commission would have every right to compensate the parents and the child for the harm they suffered under Section 14 Clause (d).
- In this case, the Supreme Court applied the principles of the Bolam test to determine whether the doctors and the hospital were negligent in their treatment of minor. The Bolam test is a legal test used to determine whether a doctor has acted in accordance with the standard of care expected of them.
- The test states that a doctor is not negligent if they have acted in accordance with a practice accepted as proper by a responsible body of medical professionals and is liable of negligence if fails to act in a responsible manner.
Bolam Test and Need for shift to Bolitho test for judgments under Medical Negligence:
- In Vinitha Ashok v. Lakshmi Hospital [(2001) 8 SCC 731)], the Hon. Supreme Court made it clear—citing Bolam, Sidaway, and Achutrao—that a doctor will be held accountable for negligence in relation to medical care and therapy even if a body of professional opinion supports his actions where it has not been established to the Court's satisfaction that such opinion is reasonable or responsible. If it can be demonstrated that the body of professional opinion cannot survive the logical analysis, the court would have the right to declare that it is neither rational nor responsible.
- The Bolitho test raises the strain on the doctor and so creates greater room for compensation, allowing for speedy alleviation.
- The Bolitho test, in contrast to the Bolam test, states that the court should not accept defence arguments as "fair," "respectable," or "responsible" without first determining whether such opinions are amenable to logical examination.
- It will be difficult for the court to hold a body of medical thought that describes itself as "reasonable," "respectable," or "responsible" to be anything other than what it represents.
- The Bolitho decision indicates that, although this will only happen in a very tiny number of cases, testimony for the medical professional who is alleged to have committed the medical negligence can be held to be irrational.
CONCLUSION:
- The case is significant in the field of medical malpractice. The ruling by the Supreme Court in this case upholds the idea that hospitals and doctors have a responsibility to treat their patients with care.
- In this case, the court determined that the hospital and the doctor were accountable for medical negligence and granted the respondent compensation for their losses. The hospital was required by the court to give the respondent reasonable care and treatment.
- In this case, the Supreme Court reaffirmed that a major medical error nearly always results in a finding of negligence. Culpability is typically applied when the wrong medicine or gas is used during an anaesthetic, and in some circumstances, the legal principle of "Res ipsa loquitur" may be applied.
- Even designating someone else as responsible can, in some circumstances, be viewed as negligence. It is deemed carelessness when a consultant delegates work to a subordinate while aware of the subordinate's inability to complete the task at hand.
- The Bolam test, which states that a doctor is not negligent if what he has done would be approved by a responsible body of medical opinion in the relevant specialty at the relevant time, is still the accepted legal norm in some cases.
- The Bolitho Test, which originated from the 1996 court case of Bolitho v. City and Hackney Hospital, modified the Bolam Test, one of the most significant rulings on medical negligence.
- According to the Bolam Test, a doctor cannot be considered negligent if they are judged to have behaved "in accordance with a responsible body of medical opinion." The Bolitho Test helped to define what was meant by "a responsible body," identifying it as one whose view had a "logical basis."
