KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, THIRUVANANTHAPURAM
B. Sudheendra Kumar, President, Ajith Kumar. D, Judicial Member and Radhakrishnan. K.R, Member
Amrutha – Appellant
versus
Deepa Nair – Respondent
First Appeal No.7 of 2024
(Arisen out of Order Dated 15/12/2023 in Case No. CC/222/2022 of District Palakkad)
Decided on 1.10.2024

IMPORTANT POINT
Issuance of medical certificate – Mental Illness – Doctors are morally & ethically bound to maintain confidentiality.

Headnote:

Indian Medical Council (Professional conduct, Etiquette & Ethics) Regulations, 2002 – Mental Health Act, 1987 – Sections 20 and 21 – Issuance of Medical Certificate in respect of patient suffering from mental ailment – Certificate was issued against the norms of Regulations, 2002 – Deficiency in service – No other provision brought to notice under Mental Health Act to issue any other form of medical certificate – Medical certificate was issued against the interest of appellant/ patient and contrary to accepted medical ethics – Consumer Protection Act is a beneficial legislation and that may be the reason why there is no provision in New Act, corresponding to Section 26 of old Act, dealing with vexatious complaints – Respondent is a lady doctor aged 38 years, still having long years of service as a doctor – This court abstains from awarding any compensation or costs, when no convincing material is available on record to indicate that act of issuing medical certificate was tainted with malice – Appellant did not press for awarding compensation – Impugned order set aside.

Held: The question now to be considered is as to whether Exhibit A1 certificate was issued against the norms of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002.

The appellant was admittedly treated as an out-patient by the respondent during December 2020 and January 2021. Therefore, the appellant and the respondent had patient-doctor relationship. The respondent had admittedly issued Exhibit A1 certificate to the husband of the appellant. In Exhibit A1 certificate, it was stated that the appellant had depression disorder with psychotic features. Exhibit A1 certificate was admittedly issued without the consent of the appellant. It appears that Exhibit A1 certificate was issued with the caption ‘To whomsoever it may concern’. The purpose for which Exhibit A1 certificate was issued is also not mentioned therein. It was also not contended that any exception to the general rule of confidentiality was available in the present case. From the above facts itself, it can be said that Exhibit A1 certificate was issued by the respondent against the doctor’s duty of maintaining secrecy. In the doctor-patient relationship, the most important aspect is the doctor’s duty of maintaining secrecy. A doctor cannot disclose to a person any information regarding his patient which he has gathered in the course of treatment nor can the doctor disclose to anyone else the mode of treatment or the advice given by him to the patient. The above discussion would clearly show that Exhibit A1 certificate was issued by the respondent against the mandates in the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002.

The Mental Health Act, 1987 does not provide any provision for issuing a certificate like Exhibit A1 in respect of a patient who is suffering from mental ailment. Sec. 21 of the Mental Health Act would show that it contains the forms and contents of the medical certificate to be issued under Sec. 20 of the said Act. Sec. 20 of the Mental Health Act deals with application for reception order. Thus, it is seen that a medical certificate under Sec. 21 of the Mental Health Act can be issued only for the purpose of reception order under the Mental Health Act. No other provision has been brought to our notice under the Mental Health Act to issue any other form of medical certificate. Thus, it appears that the Mental Health Act also does not contemplate issuance of a medical certificate like Exhibit A1 in respect of a patient suffering from mental ailment. For the said reason also, it cannot be said that Exhibit A1 certificate was issued in accordance with law and code of medical ethics. Even if the contents in Exhibit A1 certificate are true, even then issuing of such a certificate stating the mental ailment of the appellant cannot be justified.

The case sheet dated 14.12.2020 had been produced by the respondent. However, the said document was not marked. Even though the said document was not marked, since it was produced by the respondent, the same can be used against the respondent. It is clear from the said case sheet that the appellant had marital disharmony with her husband and in laws. Even then, the respondent issued Exhibit A1 certificate when the husband of the appellant alone approached the respondent. This being the situation, the contention of the respondent that the respondent was not aware that the appellant and her husband were not in good relationship, cannot be believed. However, that alone is not sufficient to hold that the respondent acted without bonafides and not in good faith. Having gone through the relevant inputs, we are of the considered view that Exhibit A1 certificate was issued against the interest of the appellant/patient and contrary to the accepted medical ethics, even if the contention of the respondent, that she issued the said certificate bonafide and in good faith, is accepted as true. Therefore, there was definitely deficiency in service on the side of the respondent.

We have already found that Exhibit A1 certificate was issued against the interest of the appellant/patient and contrary to the accepted medical ethics. The appellant was aggrieved by Exhibit A1 certificate issued by the respondent, as it contained a statement that the appellant was suffering from depression disorder with psychotic features. Even if it is assumed that Exhibit A1 certificate was issued by the respondent bonafide and in good faith, that cannot be a ground to hold that Exhibit A1 certificate was legal and proper, if the respondent had violated the confidentiality of the doctor-patient relationship. The District Commission did not incline to find out as to whether Exhibit A1 certificate was issued in violation of the provisions of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002 or not. Since the appellant was really aggrieved by the issuance of Exhibit A1 certificate by the respondent, the appellant approached the District Commission for the redressal of her grievances. Since Exhibit A1 was a medical certificate issued by the respondent violating the confidentiality of the doctor-patient relationship, there was no justification in the finding by the District Commission that the complaint was frivolous and vexatious. That apart, the complainant had raised the question of legality of Exhibit A1 certificate in the complaint. When a question of law is to be answered in a complaint, that complaint cannot be dismissed as frivolous and vexatious. For the said reasons, the finding of the District Commission that the complaint was frivolous and vexatious cannot be sustained.

A vexatious complaint is dealt with under Sec. 26 of the Consumer Protection Act, 1986 (“the old Act” for short). The said provision was deleted from the statute when the Consumer Protection Act, 2019 (“the new Act” for short) was enacted. There is also no provision in the new Act corresponding to Sec. 26 of the old Act. The Consumer Protection Act is a beneficial legislation. Probably, that may be the reason why there is no provision in the new Act, corresponding to Sec. 26 of the old Act, dealing with vexatious complaints.

Exhibit A1 certificate was issued on 11.08.2021, which was after the new Act came into force. The order impugned was passed on 15.12.2023, which was also when the new Act was in force. In the said circumstances alone, the compensation and costs ordered by the District Commission, while dismissing the complaint, cannot be justified. Even as per Sec. 26 of the old Act, the maximum costs which could be ordered while dismissing a vexatious complaint was only Rs.10,000/-. There was also no provision even under Sec. 26 of the old Act to order any compensation. There is no provision in the new Act to order any compensation or costs while dismissing a frivolous and vexatious complaint. Even though the Consumer Protection Act is a beneficial legislation to protect the interest of the consumers, the District Commission had lost sight of it and dismissed the complaint filed by the consumer with heavy penalty, even when there was no provision for doing so. This being the situation, the District Commission was not justified in ordering the compensation and costs while dismissing the present complaint.

The above discussion would show that the order passed by the District Commission cannot be sustained and consequently we set aside the same.

It appears that the respondent is a lady doctor aged 38 years. Even though the respondent had issued Exhibit A1 certificate against the medical norms, considering the fact that the respondent is a lady aged 38 years, who is still having long service as a doctor, we are taking a very lenient view and abstain from awarding any compensation or costs, particularly when no convincing material is available on record to indicate that the act of issuing Exhibit A1 medical certificate, by the respondent, was tainted with malice. That apart, the appellant did not press for awarding compensation. Moreover, we hope and wish that the respondent will be more vigilant in her profession in future. (Paras 17, 18, 19, 20, 21 to 25)

Result: Appeal Allowed.