Supreme Court awards NRI Rs 6.08 crore medical negligence compensation

Thursday, October 24, 2013

New Delhi: The Supreme Court on Thursday awarded Rs 6,08,00,550 compensation to Dr Kunal Saha, an Indian-American doctor, ordering the Kolkata-based Advanced Medicare Research Institute (AMRI) to pay for medical negligence resulting in the death of his wife Anuradha Saha in 1988.

Anuradha Saha

A bench of Justice C K Prasad and Justice V Gopala Gowda passed the order in their judgment on an appeal by Dr Saha, challenging the compensation of Rs 1.72 crore awarded by the National Consumer Disputes Redressal Commission (NCDRC). Cross appeals were also filed by AMRI and three doctors against the Commission’s award.

Welcoming the verdict, Dr Saha said the “historic” judgement should rekindle hope for countless victims.

The US-based NRI said it should tell many honest and caring doctors it is time to step forward and cleanse the system.

“If you let a few corrupt and politically connected doctors to run the show, all doctors will continue to share the blame and will never be able to restore public trust that we had not so long ago,” he said in a statement.

The court directed that the hospital would pay compensation to Dr Saha, within eight weeks, along with yearly interest of 6 per cent from the date of the complaint. Allowing AMRI to deduct what it had already paid, the court also asked to file a compliance report.

The court has asked two doctors — Dr Balram Prasad and Dr Sukumar Mukherjee — to pay Rs 10 lakh each and asked another doctor, Baidyanath Haldar, to pay Rs 5 lakh to Dr Saha.

Since three doctors, after the NCDRC decision, had already made payment in excess of one fixed by the apex court, the court said that they are entitled for reimbursement from AMRI, which should do so within eight weeks.

The court took several factors into account in fixing the compensation, over the forum’s Rs 1,34,66,000.

Noting an increasing number of medical negligence cases coming before the consumer forums, the court said it hopes this verdict “acts as a deterrent and a reminder to those doctors, hospitals, the nursing homes and other connected establishments who do not take their responsibility seriously”.

Speaking for the bench, Justice Gowda asked the central and the state governments to consider enacting laws wherever needed for effective functioning of private hospitals and nursing homes.”

Citing an earlier apex court judgment holding the right to health a fundamental right guaranteed under the Constitution’s Article 21, the court said doctors and hospitals are to be dealt with strictly if found “negligent with the patients who come to them pawning all their money with the hope to live a better life with dignity”.

“The patients irrespective of their social, cultural and economic background are entitled to be treated with dignity which not only forms their fundamental right but also their human right,” Justice Gowda said.

Since the conduct of doctors is already regulated by the Medical Council of India (MCI), the court said: “We hope and trust for impartial and strict scrutiny from the body”.

It also expressed hope that medical professionals and institutions update themselves about any new developments and rare diseases so as to avoid tragedies such as this case where a life could have been saved with a little more awareness and wisdom on the part of doctors and the hospital.

The tragic story of Anuradha started a month after she reached Kolkata in March 1998 for her summer vacation, when in April, some rashes surfaced on her skin. She consulted Dr Mukherjee who advised her rest.

However, rashes resurfaced again in early May with far greater intensity. Dr Mukherjee prescribed her two doses of Depo-Medrol injection every day.

As her condition did not improve, she was admitted to AMRI and subsequently she was shifted to Mumbai’s Breach Candy Hospital where she was diagnosed to be suffering from life-threatening disease called toxic epidermal necrolysis (TEN). At AMRI, Anuradha was treated by Dr Mukherjee.

TEN, also known as Lyell’s syndrome, is generally caused by a reaction to drugs and leads to the top layer of skin detaching from the lower layer all over the body. It is a more severe form of Stevens-Johnson syndrome.

Anuradha succumbed to her ailment on May 28, 1998. [IANS]

The Supreme Court in 2009 had found AMRI and the doctors guilty of negligence and the case was referred to the NCDRC for the sole purpose of determining quantum of compensation. The NCDRC earlier found no negligence by doctors or AMRI and had dismissed the case in 2006, forcing Dr Saha to approach the apex court.

This is by far the highest compensation in a medical negligence case. Previously, the Supreme Court, in May 2009, had awarded the highest ever compensation of Rs 1 crore to a wheelchair-bound Infosys engineer Prashant S Dhananka for medical negligence in a surgery by Hyderabad’s Nizam Institute of Medical Sciences (NIMS), which damaged his spinal chord.

Dr Kunal Saha, who had claimed a compensation of more than Rs 78 crore for his wife’s “wrongful death”, has reportedly pledged to donate the entire amount to People for Better Treatment (PBT), a voluntary group set up by him in Kolkata to fight against medical negligence and corruption in medical field.

Read the full judgement

Update: According to Dr Kunal Saha, “Anuradha died basically for receiving 80 mg Depomedrol BID continuously for almost one week. So, this was a pure and simple case of poisoning a patient with astronomical amount of a dangerous long-acting corticosteroid by the main culprit physician, Dr Sukumar Mukherjee.”

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9 Comments »

Comment by Kalyan
2013-10-25 08:04:51

Although Supreme Court is correct in pronouncing Doctors guilty, the amount of compensation given was ridiculously high which will increase the fear among Doctors while treating patients. No Doctor is God and every Doctor must have made a mistake unknowingly even after taking adequate precautions although most of them does not result in the death of the patient. Every doctor will be afraid of treating their brethren because of the fear that they may latch on to a small mistake in the treatment. The insurance coverage Doctors seek might also increase which indirectly would increase the healthcare costs. The problem happened with well trained and reputed doctors- so what will happen in the future, when the government approved half-baked doctors from many private medical colleges comes and join the practice? Should the government or the private college establishments where they are trained should be called for future disputes in the courts?

 
Comment by Dr.Sunila Sharma
2013-10-25 12:41:20

it is unfortunate to note that Dr.Kunal Saha lost his wife from a deadly disease .On scrutinizing the details of the patient management [provided in the 210 page judgement],it appears although the line of drug treatment was in the right direction ,the response to drugs prescribed in higher dosages [? desperate attempts of doctors to incite body's response] was poor and the complications of sepsis ensued.

I feel sorrow in the fact that in determining doctor’s negligence , the unpredictable response of a mortaL body to a reasonable line of treatment in restoration of health is undermined and often overlooked.

Secondly , all over the world ,different practices of medical care exist in different hospital set ups in real life,which can be termed as “usual care” and this may or may not include standard care [i.e. according to any guidelines] . Hospital infrastructures vary,standards of education vary ,doctors attitudes and talents vary .

This is the time that government agencies start grading their health care set ups in private as well as govt. sectors according to their infrastructure .MCI and State medical Councils become active in monitoring specific CMEs for the doctors/nurses/technicians for the updation of their knowledge and evaluation of the knowledge of all healthcare providers through various associations and societies of medical fraternity.

 
Comment by DR.P.L.NAWALKHA
2013-10-25 13:30:44

Stevens Johnson syndrome and related situations are predominantly fatal disorders.There are chances of limitations in providing relief by available lines of treatments,rather than NEGLIGENCE,a word pleasuresome and soothing to patients relatives,afflicted with emotional desparations.With my backround of treating STEVENS JOHNSON DURING COBALT THERAPHY TREATMENT,I SEEK PERMISSION TO COMMENT THAT CHANCES OF NEGLIGENCE ARE MINIMAL I donot find any negligence in treatment. IT IS LIMITATION OF TREATMENT CONSEQUENTIAL TO SEVERAL OF ,HITHERTO,ILL UNDERSTOOD FACTS ABOUT ITS GENESIS.IN PRESENT CASE, PUNISHMENT,PENALTY,( WITH INTERESTS) SPEAKS VOLUMES ABOUT THE VOID OF COMPREHENSION ABOUT REALISTICS OF MEDICAL SCIENCES ,EVEN IN ,APEX COURT LEVEL JUDICIARY. PRESIDENT SHOULD INTERVENE AND GET IT REVIEWED BY A BOARD CONSISTING OF TOP FIVE CONCERNED SPECIALISTS OF COUNTRY,AS THIS JUDGEMENT IS WRONG PRECEDENCE AND BASED ON ILL FOUNDED KNOWLEDGE AND COMPREHENSION.OF JUDICIARY

 
Comment by ketan
2013-10-25 14:13:13

It seems from the media reports that Depo medrol (a steroid preparation) has been given as negligent act.
In fact TEN occurs as idiosyncratic reaction to drug (means that there is no direct one to one predictable relationship with dose or drug) and Steroids are being given as part of treatment of TEN. The dosages of depo medrol are very much variable according to the condition being treated.

So there remains a confusion in masses of doctors about the technicality of the case of negligence.
I am sure that the court must have checked and counter checked the things but some more clarity needs for the masses if court wants right messages to be spread in the society.

 
Comment by ScaredToPractice-Doc
2013-10-25 17:02:23

Let’s get lawyers and draft legal contracts before touching any patient (especially non-emergency cases). That would be safer. Honestly, hospitals should seriously think about pre-treatment contracts with clauses with mutually agreed caps on liability in case of negligence. It would become impossible to practice in this country otherwise. And also, we need history check-lists in stead of blank white sheets. They should be filled in by the patients or their lawyer and signed. If defensive healthcare is what is being so desperately wanted, then defensive healthcare is what we should give.

 
Comment by neerav
2013-10-26 07:51:41

unfortunately the apex court of this country is not able to differentiate between complication and negligence. The line between complication and negligence is very thin and may not at all can be differentiated by non medical people. For ordinary people every complication is negligence. If court starts punishing for every complication how the doctors are going to practice. Even in the best of hands complications do occur, as it is medical science and not exact science like mathematics. Even recent trends of apex court in not taking opinion of experts of the field while framing negligence charges is very unfortunate and must be stopped. If this happens then every doctor will have to pay whatever they have earned in their entire life to the patients because nobody is immune to complications.

 
Comment by dr k k pandey
2013-10-26 12:06:35

This judgement should be reviewed. Doctors should meet president and prime minister to entervene.rightly said complication and negligence should be differentiated.high level expert should be formed .this judgement shows immaturity of judges about medical field. I must say save doctors.

 
Comment by Indudharan. R
2013-10-26 20:11:18

Reading through the limited edited report, I think there had been a gross misjudgement. It is sad that the patient succumbed to her illness, but that emotion should not reflect in a legal verdict. Steroid is an accepted life saving treatment in such situations and such verdicts will only lead to defensive practise of medicine and escalation of treatment costs as doctors may charge even for risk coverage.

 
Comment by SocialistCountry
2013-10-30 16:02:16

If every unfortunate incident now leads to 11 crore compensations, nobody would dare enter or stay in this field. Let’s see who these people go to for compensation when there wouldn’t even be doctors willing to treat them. Maybe, hospitals bill should come with specific sliding-scale surcharges for legal expenses based on the “nominal price” of the patient’s life. Doctors don’t mint money. If we have to pay, then it would be from your own pocket.

 
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