"Failure to Give proper treatment at proper Time is Negligence". As the deceased was Housewife, Supreme Court saddled Rs.15 lakhs compensation.

"Failure to give proper treatment at proper Time is Negligence". As the deceased was Housewife, Supreme Court saddled Rs.15 lakhs compensation by holding that Contribution made by Housewife has an economic equivalent. An Important Judgment indeed. 

Case details :

Arun Kumar Manglik V/s. Chirayu Health and Medicare Pvt. Ltd & anr.

Civil Appeal No.227/228 of 2019, decided on 09/01/2019.

Coram :

Hon. Dhananjay Chandrachud and Hon. Heman Gupta, JJ.

Judgment Link.

https://www.sci.gov.in/supremecourt/2016/27594/27594_2016_Judgement_09-Jan-2019.pdf

Facts of the case in short :

1. The Complainant approached M.P. State Consumer Forum for claiming Rs.48 lakhs as compensation. However the forum granted Rs.6 lakhs as the deceased patient was Housewife. This judgment was reversed by National Commission and hence the Complainant approached Hon. Supreme Court.

The 56 years old wife - patient of the Appellant-complainant was admitted in the Respondent Hospital at Bhopal on 15/11/2009 @ about 7.00 am, due to Dengue fever symptoms. 

2. One day prior to her admission, the platelate count was 1.79 lakhs, which dropped to 97000 when she was admitted. Since the patient was complaining about abdominal pain, her Sonography was also conducted. 

3. By 6 pm on the date of admission, the patient was sinking. Her BP was non recordable, extremities were cold and pulse was not palpable. Meantime she was placed on intravenous fluids. The patient developed bradycardia and cardiac arrest. Thus the supply of fluids was increased. At 6.45 pm she had a cardiac arrest. The Blood sample taken @ 7.15 showed steep decline in platelate count to 19000. At 8 pm the patient had cardiac arrest and at 8.50 pm she was declared dead.

4. It was alleged by the Complainant that the Doctors failed to follow Standard Treatment Protocol and the guidelines issued by WHO. There was no regular monitoring, which was very essential. 

5. The Hospital rejected all the allegations. It was alleged that the patient had fever for 15 days prior to her admission. The Doctors followed the standard protocol treatment inspite of it the patient could not be saved. the treatment was given as per WHO protocol and as per the National  Vector Borne Decease Programme. The Doctors performed their duty of reasonable care based on their reasonable degree of skill and care. 

6. In the meantime the Ethics Committee of Medical Council of India vide its report observed that the Doctors gave proper treatment, but it was not given in requisite time and reprimanded Doctors to take precaution henceforth.

Held :

1. After considering the documents on record, Medial Literature and argument of parties, Hon. Apex Court held the Hospital Negligent, however absolved its Medical Director, since he was not personally involved in the Treatment. 

2.  The Apex  held that as between 7.30 am to 7 pm the critical parameters were not evaluated and simple expediment of monitoring blood parameters was not done,  it was in contravention of WHO guidelines as well as the guidelines prescribed by the Directorate of National Vector Borne Diseases Control ProgramIt also relied upon the report of Ethics Committee of MCI. It turned down the allegations of Hospital as conjecture  wherein Hospital alleged that taking of Blood samples would have been resisted by the family of the deceased. 

3. The Hon. Apex Court referred to catena of Judgments of Apex Court as well as that of Foreign Courts on the point of Negligence.
IT referred to the famous judgment of Kusum Sharma V/s. Batra Hospital, (2010) 3 SCC 480, wherein it was held that 
"A medical practitioner would be liable only where the conduct falls below the standards of a reasonably competent practitioner in the field".
It then refereed to the oft-quoted judgment of Queens Bench in the year 1957, England, on the basis of which it is said that Indian Medical Jurisprudence is based, i.e. Bolam v Friern Hospital Management Committee, commonly known as Bolam's Test, which stressed the "reasonableness" as the test to decide Negligence.
A three judge Bench of this Court in Dr Laxman Balkrishna Joshi v Dr Trimbak Bapu Godbole (AIR 1969 SC 128) held that "...The practitioner must bring to his task a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor a very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires"
It then turned to another landmark judgment of Jacob Mathew V/s. State of Punjab (2005)6 SCC 1, wherein Hon. Apex Court referring to Bolam Test held that, "...The fact that a defendant charged with negligence acted in accord with the general and approved practice is enough to clear him of the charge.."
Then it relied upon the Landmark judgment of Apex Court in the case of Indian Medical Association v V P Shantha (1995) 6 SCC 651, which brought the Medical Professionals under C.P. Act, "wherein it was observed that Medical practitioners do not enjoy any immunity and they can be sued in contract or tort on the  ground that they have failed to exercise reasonable skill and care.” 

4. Compensation :
The Apex Court while deciding the factor of Compensation on death of a Housewife, held that the complainant has lost his spouse, who was 56 years of age. Though she was not employed, it is now well settled by a catena of decisions of this Court that the contribution made by a non-working spouse to the welfare of the family has an economic equivalent. (Lata Wadhwa V/s. State of Bihar (2001) 8 SCC 197 ). 
In the case of Malay Kumar Ganguly V/s. Sukumar Mukharjee (2009)3 SCC 663, the Apex Court held that".... Even otherwise a wife's contribution to the family in terms of money can always be worked out. Every housewife makes a contribution to his family. It is capable of being measured on monetary terms although emotional aspect of it cannot be. It depends upon her educational qualification, her own upbringing, status, husband's income, etc.”

Thus at last it enhanced the compensation to Rs.15 lakhs from 6 lakhs to meet the ends of justice, with interest @9% p.a.

This judgment is very important. It emphasizes important principle that "proper Treatment at proper time" has no alternative. In India There are numerous instances of Dengue fever and thus Doctors should learn from the mistakes of others.
Another important factor is of compensation, wherein Hon. Apex Court has considered the work and efforts made by Housewives. It means now the Court has started considering the status of per-se unemployed  persons for awarding compensation. 

Thanks and Regards

Adv. Rohit Erande
Pune.©