Proper Informed Consent for DNR saved Apollo Hospital from Rs.20 lakhs of compensation... !

Proper Informed Consent for DNR ( Do Not Resuscitate) saved Drs from Rs.20 lakhs of compensation... !

APOLLO SPECIALTY HOSPITAL & ANR., CHENNAI V/s. R. MUTHUKRISHNAN.

http://cms.nic.in/ncdrcusersWeb/GetJudgement.do?method=GetJudgement&caseidin=0%2F0%2FFA%2F586%2F2015&dtofhearing=2016-08-31
Dated : 31 Aug 2016

Allegations of the Complainant :
1. The 12 year son of the Complainant was diagnosed as Acute Myeloid Leukemia (AML). Afterwards the Drs. forced Complainant to undergo Bone Marrow Transplant (BMT)) treatment urgently.
2. Thereafter due to further complications, the patient died. it was solely due to negligence on part of Drs. the hospital instead of giving palliative treatment, adopted DNR (do not resuscitate) protocol. Hospital did not give record within 72 hrs. The consent was taken by misrepresentation and suppression of material facts. The state Commission of Chennai allowed the Complaint. Hence the Appeal before National Commission was filed.

Held :
1. As per medical text books the disease AML is a dreaded disease of blood cancer, and due to suppression of immune system during the treatment, most of the patients develop several side effects like infections.
2. In the instant case, the patient was monitored by CMV investigations and accordingly the medication was given.  The patient was already immunocompromised, thus develops infections and there was no cure.  In our view, it can’t be considered to be a medical negligence or deficiency in service by the treating doctors.
3.In the instant case, extensive search was made by OP for matching BMT but no matching donor was identified.
4.The death of the patient was due to number of known complications, which are consequences of BMT.  In our considered view, there was no medical negligence either in the procedure of BMT or in the care during post BMT complications.  The patient was treated with proper informed as discussed by Hon’ble Supreme Court in Samira Kohli’s case 2008 (1) CTC.

DNR presupposes proper counseling with patient's relatives. As far as possible do have a recording of this counseling session. That will be an added benefit for Drs.


Medicos, Great decision indeed. Informed consent is a condition precedent for any treatment. It is indeed unfortunate for any parent  to lose their son/daughter at such early age. But we have to admit that Medical  Science is not a complete science, but it's a developing science and hence it has its own limitations... Drs. are aware it and patients are required to be made aware of it.. isn't it ?

Thanks and Regds

Adv. Rohit Erande
Pune.©

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