Burden to Prove Breach of Duty, Injury, and Causation Lies on Claimant: NCDRC Allows Fortis Hospital's Appeal, Sets Aside State Commission's Compensation Order in Medical Negligence Case
Pranav B Prem
The National Consumer Disputes Redressal Commission (NCDRC) Bench comprising Dr. Inder Jit Singh (Presiding Member) and Dr. Sadhna Shanker (Member) allowed an appeal preferred by Fortis Hospital, Mohali, along with its associated doctors, challenging the decision of the State Consumer Disputes Redressal Commission, Punjab, which had earlier directed the Hospital and doctors to pay Rs. 15 lakh to the complainant on grounds of alleged medical negligence. The NCDRC held that the complainant had failed to establish breach of duty, causation, and injury attributable to the Hospital and its medical staff.
The case originated from a complaint lodged by Smt. Mohinder Kaur through her legal representatives. The complainant had undergone total knee replacement surgery at Fortis Hospital, after which she reportedly experienced severe back pain and numbness in one of her legs. This complaint was brought to the attention of the orthopedic surgeon, who assured that these symptoms were likely the effects of anaesthesia and painkillers and would resolve in a day or two. However, the complainant soon reported numbness in the other leg as well. On persistent complaints, the hospital referred her to a neurosurgeon, Dr. V. K. Khosla, who conducted an MRI of the lumbar spine. The MRI revealed a spinal subdural/epidural hematoma, which necessitated a decompressive laminectomy and blood transfusion.
The complainant alleged that there was a delay in performing corrective surgery, which resulted in paralysis of her lower limbs. On this basis, she approached the State Commission, claiming compensation of Rs. 15 lakh for alleged medical negligence, along with additional amounts for refund of medical expenses and mental and physical suffering.
The Hospital and the concerned doctors contested the allegations, arguing that the complainant had failed to produce any expert evidence to establish negligence. They submitted that the complainant was 78 years old, suffered from multiple co-morbidities including osteoarthritis, hypertension, coronary artery disease, and cardiac dysfunction, and that she had a history of palpitations. It was contended that the patient was administered spinal and epidural anaesthesia in accordance with standard medical protocols, and prophylactic measures like Clexane injections were given to prevent clot formation, which is common after knee replacement surgeries. When complaints of numbness arose, necessary steps were immediately taken, including stopping all blood thinners and performing a decompressive surgery. The hospital emphasized that the epidural hematoma is a rare but recognized complication of spinal anaesthesia, and its occurrence cannot by itself be construed as medical negligence.
The orthopedic surgeon also argued that the complainant was not a ‘consumer’ as defined under the Consumer Protection Act, and that the complaint was barred by limitation. The anesthetist took the stand that he had no direct contractual relationship with the complainant as he was merely an employee of the hospital.
The State Commission had earlier found the hospital and doctors liable and directed them to pay Rs. 15 lakh in compensation to the complainant. Aggrieved, the hospital and doctors preferred an appeal before the NCDRC.
Upon considering the submissions, the NCDRC referred to various judgments, including PGIMER Chandigarh vs. Jaspal Singh [ (2009) 7 SCC 330], wherein the Supreme Court held that in cases of medical negligence, the burden to establish breach of duty, causation, and injury squarely lies on the claimant. The Commission noted that the complainant was unable to produce any expert evidence or credible material linking the alleged disability to the surgery or any act of omission by the hospital or its doctors.
The NCDRC observed that the medical records did not support the claim that the delay in corrective surgery led to paraplegia. The Commission pointed out that as per the prescription dated 23.08.2013 issued by Dr. V. K. Khosla, the patient was walking with support, which contradicted the complainant’s claim of complete paraplegia. Additionally, the disability certificate relied upon by the complainant was issued in 2016, was not valid for medico-legal purposes, and recorded the condition as paraparesis (partial weakness of the limbs) rather than complete paralysis.
The NCDRC further noted that offering a discount on the medical bill cannot be taken as an admission of liability or negligence. It emphasized that without expert medical evidence to establish the essential elements of negligence, no inference of breach of duty could be drawn against the hospital or its doctors.
In conclusion, the NCDRC held that the complainant failed to prove medical negligence on the part of the hospital or the treating doctors. Consequently, the appeal filed by Fortis Hospital and the doctors was allowed, the impugned order of the State Commission was set aside, and the consumer complaint was dismissed.
Appearance
Advocate for the Appellant (Smt. Mohinder Kaur): Mr R.C. Gupta
Advocate for the Respondents: Mr Rohit Puri, Mrs Kanchan Bahl and Mr Aditya Awasthi [For Fortis Hospital and Dr Sandeep Khurana]; Ms Anshima Sawhney [For Dr Manuj Wadhwa]
Cause Title: Mohinder Kaur V. Fortis Hospital and Ors.
Case No: First Appeal No. 698 of 2017
Coram: Hon’ble Dr. Inder Jit Singh [Presiding Member], Hon’ble Dr. Sadhna Shanker [Member]
[Read/Download order]
