Understanding Legal Consequences Of Medical Negligence

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Index 

  1. Introduction 
  2. Understanding Medical Negligence In Legal Contexts
  3. Bolam Test And Legal Standards In Medical Negligence Cases
  4. Bolitho Test And Legal Scrutiny In Medical Negligence Cases
  5. What Leads To Negligence
  6. Repercussions Of Medical Negligence 
  7. Legal Ramifications Of Death By Medical Negligence
  8. Legal Guidelines On Medical Negligence By The Supreme Court Of India
  9. Conclusion

Introduction 

Medical negligence occurs when there’s a breach of the duty of care, resulting in harm or damage to the patient. This harm can be in various forms such as financial loss, health deterioration, worsening the patient’s condition, causing emotional trauma, or leaving the patient in a permanent debilitating state. 

India’s legal framework, heavily influenced by English law, incorporates many principles from English legal history. One such influential case is Bolam v. Friern Hospital Management Committee (1957), which established a test for medical negligence. However, in 2001, English courts abandoned this test, opting for stricter requirements in proving medical negligence. Despite this change, Indian courts continue to adhere to the principles set forth in Bolam’s case.

Understanding Medical Negligence In Legal Contexts

In the realm of law, medical negligence refers to the violation of a duty of care, resulting in harm to the patient. This harm can manifest in various ways, including financial losses, deterioration of health, exacerbation of existing conditions, emotional trauma, or leaving the patient in a permanently debilitating state.

Bolam Test And Legal Standards In Medical Negligence Cases

The Bolam test originated from the legal case Bolam v. Friern Hospital Management Committee in 1957. In this case, Mr. John Hector Bolam sought treatment for depression at Friern Hospital. The doctor responsible for his care did not administer muscle-relaxant drugs, leading to the plaintiff sustaining fractures in both hips. Consequently, the plaintiff sued the hospital, alleging negligence on the part of the doctor in fulfilling his responsibilities. Additionally, the plaintiff argued that had he been informed of the risks, he would not have pursued the therapy, highlighting negligence within the medical profession.

In the Bolam v. Friern Hospital Management Committee case, the court ruled in favour of the defendant, stating that the doctor and nurses were not liable for their actions. The court reasoned that it was not customary for doctors to disclose procedure risks at that time. Expert testimonies varied regarding the use of muscle relaxants, with many experts indicating they would not have administered them. This diversity of expert opinions led the court to conclude that the medical professionals had not acted negligently in treating Mr. Bolam.

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The test for determining negligence, as articulated in the judgement, states that a doctor is not negligent if they follow practices accepted by a responsible body of skilled medical professionals. Conversely, acting in accordance with such practices does not constitute negligence, even if there is dissenting opinion. 

Furthermore, the judgement emphasised that the standard for assessing negligence in cases involving specialised skills is not that of an average person but rather of a skilled professional in the respective field. A doctor is not deemed negligent if they demonstrate ordinary skill as expected within their profession, as determined by a responsible body of medical experts.

Bolitho Test And Legal Scrutiny In Medical Negligence Cases

The Bolitho v. City and Hackney Health Authority (1997) case led to the development of the Bolitho test, challenging the traditional approach to medical negligence set by Bolam. In 1984, two-year-old Patrick Nigel Bolitho was admitted to St. Bartholomew’s Hospital with croup. Despite being discharged initially, his condition worsened the next day, prompting readmission and nurse supervision. Unfortunately, the child suffered brain damage and later died, leading to a negligence case filed by his parents against the hospital.

The House of Lords found the attending medical officer guilty of negligent conduct. To determine if the doctor’s actions could have saved the child, the court consulted eight experts. While five experts would have intubated the child, three disagreed. Consequently, the accused doctor was not found guilty of negligence.

The court emphasised the need for a logical basis in medical opinions, using terms like “responsible, reasonable, and respectable.” Especially in cases involving risk-benefit analysis, the judge must ensure that experts consider comparative risks and benefits to form a defensible conclusion.

What Leads To Negligence 

The court ruling in Bolam’s case stated that negligence occurs if an error wouldn’t have been made by a reasonably skilled professional acting with ordinary care. Conversely, if the error is one that such a professional might have made despite ordinary care, it does not constitute negligence.

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In the case of Kusum Sharma & Ors v. Batra Hospital & Medical Research (2010), the Supreme Court of India defined negligence as the failure to fulfil a duty either by omitting an action that a reasonable person would do or by taking an action that a prudent and reasonable person would not do, based on common considerations governing human conduct.

To prove negligence against a doctor, several criteria must be met:

  1. Duty of Care: It must be shown that the doctor had a responsibility to provide care to the patient or individual who suffered harm, whether physical or mental. Failure to fulfil this duty can lead to accusations of medical negligence and potential expulsion from practising medicine.
  2. Breach of Duty: The next step is demonstrating that despite having a duty of care, the doctor did not fulfil it and breached their professional obligations.
  3. Causation of Harm: It’s essential to establish that the doctor’s breach of duty directly led to injury or death for the patient. 

All these elements must be proven in a court of law to establish negligence on the part of the doctor.

Repercussions Of Medical Negligence 

Medical negligence carries various repercussions such as:

  1. Increased Costs: It leads to additional medical expenses like surgeries, therapies, and hospital admissions, escalating overall bills.
  2. Insurance Depletion: Patients rely more on insurance, depleting their savings and health coverage.
  3. Prolonged Legal Processes: Medical negligence cases often involve lengthy court proceedings, causing stress for both parties.
  4. Aggravation of Initial Condition: Negligence can worsen the patient’s condition, leading to more complications and injuries.
  5. Lifelong Trauma: Patients may suffer long-term psychological and emotional trauma, prolonging recovery.
  6. Unnecessary Procedures: Negligence can necessitate additional surgeries to rectify or compensate for the initial malpractice

Legal Ramifications Of Death By Medical Negligence

Death resulting from medical negligence falls under Section 304A of the Indian Penal Code, 1860 (IPC), where punishment for causing death due to a rash and negligent act can lead to a maximum sentence of two years, a fine, or both.

However, not every medical error qualifies as a criminal offence under Section 304A of the IPC. The act must involve gross negligence on the part of the medical professional to be considered a criminal act.

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In the case of Kurban Hussein Mohammedali v. State Of Maharashtra (1964), it was established that for criminal liability under Section 304A of the IPC, the death must directly result from a rash and negligent act by the accused. This act must be the immediate and predominant cause of death without the influence of another party’s negligence.

Legal Guidelines On Medical Negligence By The Supreme Court Of India

In the case of Jacob Mathew v. State Of Punjab & Anr (2005), the Supreme Court of India outlined specific guidelines regarding medical negligence:

  1. Complaint Verification: A complaint alleging medical negligence must be supported by prima facie evidence before it can be considered by the court.
  2. Expert Consultation: Before taking legal action against an accused doctor, the appointed investigating officer must consult with an unbiased and impartial doctor from government services. This expert must assess the case using Bolam’s test to determine the presence of negligence.
  3. Non-Routine Arrest: The accused doctor should not be arrested routinely unless deemed necessary for further investigation. Arrest may also be justified if the investigating officer believes that the doctor may evade prosecution.

Conclusion 

Medical negligence represents a grave breach of professional conduct among medical practitioners, as they are entrusted with preserving and improving lives. Unfortunately, instances of medical negligence leads to immense pain and suffering for patients. To mitigate such misconduct, the Indian government and the medical community must enhance the education standards for medical professionals and emphasise the importance of ethical conduct.

While the concept of medical negligence is well-established in India, the legal system still relies on the outdated and vague Bolam’s test. It is imperative for the Indian judiciary to adopt modern methods for assessing medical negligence.

In order to ensure justice for victims of medical negligence, the Indian judiciary should embrace new approaches to prevent prolonged legal battles and alleviate the sufferings of individuals. In cases where medical negligence is proven, stricter punishments could be imposed on those found guilty, along with substantial fines for hospitals employing such negligent professionals.

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