2009 (9) TMI 931 - SC - Indian Laws

Whether there was any negligence of the doctors who treated the appellant? Whether the death of A was caused by poison. The opinions of experts as to the symptoms produced by the poison by which A is supposed to have died, are relevant? Whether A, at the time of doing a certain act, was by reason of unsoundness of mind, in capable of knowing the nature of the act, or that he was doing what was either wrong or contrary to law. The opinions of experts upon the question whether the symptoms exhibited by A commonly show unsoundness of mind, and whether such unsoundness of mind usually renders persons incapable of knowing the nature of the acts which they do, or knowing that what they do is either wrong or contrary to law, are relevant? Whether a certain document was written by A. Another document is produced which is proved or admitted to have been written by A. The opinion of experts on the question whether the two documents were written by the same person or by different persons are relevant?

Issues Involved:
1. Medical negligence by the respondents.
2. Correct surgical procedure for Pott's disease.
3. Duration of pre-surgery anti-tubercular treatment.
4. Necessity of immediate surgery.
5. Consultation with an orthopedic surgeon.
6. Expert opinion and its non-compliance by the National Commission.

Issue-wise Detailed Analysis:

1. Medical Negligence by the Respondents:
The appellant filed a complaint alleging medical negligence by the respondents, claiming that the treatment he received worsened his condition and left him handicapped. The National Commission concluded that medical negligence was not proved, stating, "Medical negligence is when a doctor did something which he ought not to have done or did not do what he ought to have done. The doctors were qualified professionals. They did whatever was required to be done of Neuro-Surgeons."

2. Correct Surgical Procedure for Pott's Disease:
The appellant contended that the correct method of operating his infection was Antero-Lateral Decompression (ALD) and not Laminectomy. The Commission did not address this specific contention in detail, focusing instead on the broader issue of whether there was negligence in the treatment provided.

3. Duration of Pre-surgery Anti-Tubercular Treatment:
The appellant argued that he was kept on anti-tubercular drugs for only one week before the surgery, which is shorter than the accepted medical practice. The Commission did not specifically address this issue in its judgment.

4. Necessity of Immediate Surgery:
The appellant claimed that there was no requirement for immediate surgery. The Commission did not provide a detailed analysis of this claim, focusing instead on the overall treatment process and the qualifications of the doctors involved.

5. Consultation with an Orthopedic Surgeon:
The appellant argued that the neurosurgeon (respondent no. 2) did not consult an orthopedic surgeon, which he believed was necessary. The Commission did not specifically address this issue in its judgment.

6. Expert Opinion and its Non-compliance by the National Commission:
The appellant contended that the Commission did not have the benefit of expert opinion due to non-compliance by the Registry of the National Commission. The Supreme Court noted that the Assistant Registrar failed to forward the original records and X-Ray films to the expert, Dr. A.K. Singh, which hindered his ability to provide a complete opinion. The Court emphasized the importance of expert opinion in medical negligence cases, stating, "The law of evidence is designed to ensure that the court considers only that evidence which will enable it to reach a reliable conclusion."

Conclusion:
The Supreme Court allowed the appeal, setting aside the National Commission's order and directing the Registrar to forward all treatment records to Dr. A.K. Singh for his expert opinion. The Court emphasized that the appellant should not suffer due to the negligence of the Assistant Registrar and highlighted the principles of natural justice, stating, "The principles of Natural Justice require that a fair opportunity should be given to the complainant to prove his claim based on the report of the expert." The case was remanded to the National Commission for a fresh order based on the expert opinion.

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