New Delhi: In a precedent-setting judgement that set a new benchmark for damages in a case of medical negligence, the Supreme Court (SC) has asked a Hyderabad hospital to pay Rs1 crore compensation to a Bangalore-based software engineer.
The judgement could also see more such cases—which are usually settled between the parties—reaching the courts.
Lawyers said the Rs1 crore compensation is the highest ever awarded in a case of medical negligence in India and added that the judgement could define the compensation to be paid by errant hospitals and doctors in similar cases.
The apex court’s verdict could also see a rush by doctors and hospitals for insurance cover.
On Thursday, justice H.S. Bedi delivered the verdict and asked Nizam’s Institute of Medical Sciences (Nims) to pay Rs1 crore to Prashant S. Dhananka as compensation, enhancing the penalty awarded earlier by the National Consumer Disputes Redressal Commission (NCDRC).
Nims had appealed to the Supreme Court in 1999 after NCDRC had awarded Rs14 lakh to be paid to the patient, Dhananka, Rs1.5 lakh to his father and Rs25,000 as costs.
The case dates back to 1990.
“So far, courts have awarded a maximum compensation of Rs7-8 lakh in such cases,” said Rahul Singh, assistant professor of law at the National Law School of India University, Bangalore who termed the apex court’s award “first-of-its-kind”.
In 1993, Dhananka had moved NCDRC seeking damages of Rs5 crore for medical negligence.
In September 1990, he had been admitted to Nims after tests showed that he had a tumour in his chest. A surgery was conducted on him to remove a sample of the tumour to examine if it was malignant. Dhananka alleged that the surgeon found the tumour to be benign, but without consulting a neurosurgeon, he went ahead and removed the tumour, damaging blood vessels connected to the spine, leaving him paralysed below the waist.
Dhananka, who argued his case in person, said that the judgement would bring clarity on the damages awarded in such instances. “There was no precedent on damages as most cases are settled outside courts,” he added.
The court’s ruling also sheds light on the civil liability of doctors, said Singh, who added that the Supreme Court had already set norms for criminal liability of errant doctors and hospitals.
Those norms, however, set through the judgement in the 2005 case Jacob Matthew vs Punjab, are stringent and prescribe a very high standard of proof. Singh said that this favoured doctors.
“Though previous cases talked about criminal liability, the courts left the question of compensation as civil liability open. Now, by awarding such a high amount, there is a modicum of relief for the patients. This has reinstalled a balance between the rights of doctors and patients.”
Healthcare industry executives admit that the judgement would make doctors more careful. Vishal Bali, chief executive of Wockhardt Hospitals, and Dr Parvez Ahmed, CEO and managing director of Max Healthcare, said that the judgement is a “wake up call” to the medical industry.
In October 2008, Jayant Bhuyan, a senior executive at industry lobby group Confederation of Indian Industry died after undergoing surgery at a hospital run by Max.
A Mint report, and several other media reports had pointed to possible issues related to medical negligence in the death. No case has been filed in this instance.
Ahmed, however, stressed the need for balance.
“You might be aware that the Supreme Court has also made a ruling that to prove medical negligence, there has to be peer review by three peers, so it protects frivolous suits. The law should be on the side of the physician and the affected person, both. I think there should be no difference between the judgements for state or private hospitals. I hope the government hospital in question has liability and malpractice insurance,” he said.
Mint couldn’t immediately confirm whether Nims has such insurance, which, according to Rahul Aggarwal, CEO of Optima Insurance Brokers Pvt. Ltd, “covers the court award and legal expenses”.
“We have come to know about the Supreme Court decision through the media and don’t know the exact contents of the order. We are awaiting for the order copy so that we can examine the legal options available before us and decide on the course of action,” said Dr N. Satyanarayana, medical superintendent at Nims.
Dr Mira Shiva, committee member of the People’s Health Movement—a coalition of civil society organizations, non-governmental organizations, social activists, health professionals and academics—said she wasn’t sure of Nims’ ability to find the money to pay the damages.
“If the hospital has to cough up so much, then I am wondering what could be the implications on their provisions for poor people since this is a government hospital,” she added.
Radhieka Pandeya and Teena Jain in New Delhi, and C.R. Sukumar in Hyderabad contributed to this story.