2010 (3) TMI 1179 - SC - Indian Laws

Summary

Issues Involved:
1. Negligence on the part of the respondent doctor and hospital.
2. Requirement of expert evidence in proving medical negligence.
3. Application of the Bolam test in medical negligence cases.
4. Distinction between civil and criminal negligence.
5. Applicability of the principle of res ipsa loquitur in medical negligence cases.
6. Validity of the directions given in Martin F. D'souza v. Mohd. Ishfaq regarding expert evidence.

Detailed Analysis:

1. Negligence on the Part of the Respondent Doctor and Hospital:
The appellant, an officer in the Malaria department, admitted his wife to the respondent hospital due to fever and chills. Despite tests showing no malaria, the patient was treated for Typhoid. The appellant alleged negligence, citing the presence of particles in the saline bottle and unnecessary administration of artificial oxygen. The patient's condition deteriorated, leading to her transfer to Yashoda Hospital, where she was diagnosed with malaria and subsequently died. The District Forum found negligence, awarding compensation to the appellant. However, the State Commission overturned this, citing a lack of expert evidence to prove negligence.

2. Requirement of Expert Evidence in Proving Medical Negligence:
The Supreme Court emphasized that expert evidence is not always necessary to prove medical negligence. The Court noted that the State Forum did not find the case complicated enough to require expert opinion. The Court reiterated that each case should be judged on its own facts, and a mechanical approach requiring expert evidence in all cases would burden the remedy under the Act, making it illusory.

3. Application of the Bolam Test in Medical Negligence Cases:
The Bolam test, which states that a doctor is not negligent if acting in accordance with a practice accepted as proper by a responsible body of medical professionals, was discussed. The Supreme Court noted that while the Bolam test is accepted in India, it has faced criticism in its country of origin for potentially lowering medical standards. The Court suggested reconsidering the parameters of the Bolam test in light of Article 21 of the Indian Constitution, which guarantees the right to medical treatment and care.

4. Distinction Between Civil and Criminal Negligence:
The Court distinguished between civil and criminal negligence, noting that criminal negligence requires a higher degree of negligence, often involving 'mens rea' (guilty mind). The Court referenced the case of Jacob Mathew vs. State of Punjab, which emphasized that negligence in criminal law must be of a very high degree to constitute an offense, unlike in civil law where it may lead to liability for damages.

5. Applicability of the Principle of Res Ipsa Loquitur in Medical Negligence Cases:
The principle of res ipsa loquitur, which allows negligence to be inferred from the mere occurrence of certain types of accidents, was upheld. The Court noted that in cases of evident negligence, the burden shifts to the respondent to prove that proper care was taken. The Court provided examples where this principle applies, such as burns from medical equipment or infections from surgery.

6. Validity of the Directions Given in Martin F. D'souza v. Mohd. Ishfaq Regarding Expert Evidence:
The Supreme Court found the directions in Martin F. D'souza, which mandated expert evidence in all medical negligence cases before issuing notice, to be inconsistent with larger bench decisions and the Consumer Protection Act. The Court emphasized that the Consumer Fora should have the discretion to decide whether expert evidence is necessary based on the facts of each case. The directions in D'souza were deemed contrary to the principles laid down in Indian Medical Association vs. V.P. Shantha and Dr. J.J. Merchant, which allowed for summary trials in simple cases of medical negligence.

Conclusion:
The Supreme Court restored the order of the District Forum, which found negligence on the part of the respondent hospital and awarded compensation to the appellant. The Court held that expert evidence was not necessary in this case and emphasized the need for Consumer Fora to exercise discretion in requiring expert evidence. The appeal was allowed with costs assessed at Rs. 10,000 to be paid by the respondent within ten weeks.