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2023 Supreme(SC) 1047

A. S. BOPANNA, PRASHANT KUMAR MISHRA
Kalyani Rajan – Appellant
Versus
Indraprastha Apollo Hospital – Respondent


Advocates appeared:
For the Appellant(s) : Mr. Nikhil Nayyar, Sr. Adv. Mr. T. V. S. Raghavendra Sreyas, AOR Ms. Sugandha Batra, Adv. Ms. Gayatri Gulati, Adv. Mr. Divyanshu Rai, Adv. Mr. Siddharth Vasudev, Adv.
For the Respondent(s): Ms. Radhika Gupta, AOR Dr. Lalit Bhasin, Adv. Ms. Nina Gupta, Adv. Ms. Ananya Marwah, Adv. Ms. Meenakshi Arora, Sr. Adv. Mr. Rahul Narayan, AOR Mr. Adil Vasudeva, Adv. Mr. Chander Tanay Chobe, Adv.

Judgement Key Points

Key Points: - The court held that Res Ipsa Loquitur does not apply given the lack of a ‘Res’ and the absence of strong incriminating evidence linking post-operative care to the cardiac arrest (!) (!) . - The evidence shows no prior heart problems or diabetes/hypertension; standard practice permitted sending patients to wards rather than ICU if no complications, and no negligence was proven in post-operative care (!) (!) (!) . - Expert opinions (e.g., Prof. Ahuja) concluded the complications were unrelated to the surgery and not indicative of cardiac arrest symptoms, supporting dismissal of negligence claims (!) (!) . - The respondent hospital and doctors were found not liable for medical negligence; standard of care judged against ordinary competent practice at the relevant time (!) (!) . - The Tribunal noted that negligence cannot be presumed from a poor outcome; there must be clear medical evidence of negligence or a glaring lapse, which was not established here (!) (!) . - The appeal was dismissed, affirming that post-operative care did not breach the standard of care and that no causal link to the death was proven (!) .

What is the applicability of the principle of Res Ipsa Loquitur in medical negligence claims in this case?

What is the court’s view on post-operative care standards and the necessity of ICU transfer after major neurosurgery?

What is the standard of proof and the tested connection between post-operative care and cardiac arrest leading to death?


JUDGMENT :

PRASHANT KUMAR MISHRA, J.

The present appeal is directed against the order passed by the National Consumer Disputes Redressal Commission1[(for short, ‘the Commission’)] dated 03.08.2010 whereby the complaint filed by the appellant and proforma respondent No. 3 under Section 2 (c)(iii) of the Consumer Protection Act, 19862[(for short, ‘the Act’)] was rejected.

2. The complainant-appellant is the wife of the deceased patient namely, Sankar Rajan3[(for short, ‘the deceased’)], who was 37 years old and died on 06.11.1998 in the hospital-respondent no. 1 herein while undergoing follow up care and treatment after a major neurosurgery in the care of respondent nos. 1 and 2. The deceased was under the employment of proforma respondent no. 3 and was earning handsome annual package at the time of his demise.

3. The deceased was suffering from Chiari Malformations (Type II) with Hydrocephalous. The deceased consulted Dr. Ravi Bhatia – respondent no. 2, Senior Consultant, Department of Neurosurgery of respondent no. 1-hospital on 21.10.1998, who advised him to get admitted to respondent no. 1-hospital where the surgery would be performed by him. As per the advice of respondent no. 2, th


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