High Court Of Rajasthan
Judgename : Arun Madan
Rajmal - Appellant
Versus
State of Rajasthan - Respondent
S.B. Civil Miscellaneous Application No. 34 of 1990
Decided On : 11/03/1995
MEDICAL NEGLIGENCE - LAPROSCOPIC TUBECTOMY - DEATH OF PATIENT - VICARIOUS LIABILITY - COMPENSATION - MEDICAL EQUIPMENTS - MANDATORY AVAILABILITY - RES IPSA LOQUITUR - DOCTRINE OF VICARIOUS LIABILITY - STATE GOVERNMENT'S LIABILITY - COMPENSATION AWARDED.
Fact of the Case:
The petitioner's wife died during a laparoscopic tubectomy operation at a Primary Health Centre. An inquiry committee was constituted by the State Government to investigate the matter. The committee found that the death was caused by neurogenic shock resulting in cardiac arrest, caused by insertion of pneumo peritoneal needle. The committee also found that there was no wilful negligence on the part of the doctor who conducted the operation.
Finding of the Court:
The court held that the State Government was vicariously liable for the death of the petitioner's wife since the doctor who conducted the operation was an employee of the State Government. The court also held that the State Government was negligent in not providing adequate medical equipments to the hospital where the operation was conducted.
Issues: 1. Whether the State Government was vicariously liable for the death of the petitioner's wife? 2. Whether the State Government was negligent in not providing adequate medical equipments to the hospital where the operation was conducted?
Ratio Decidendi: 1. The court held that the State Government was vicariously liable for the death of the petitioner's wife since the doctor who conducted the operation was an employee of the State Government. The court relied on the principle of vicarious liability and the doctrine of 'res ipsa liquitor' to hold the State Government liable. 2. The court held that the State Government was negligent in not providing adequate medical equipments to the hospital where the operation was conducted. The court relied on the recommendations of the inquiry committee which found that the death of the patient could have been avoided if adequate medical equipments were available.
Final Decision: The court directed the State Government to pay compensation of Rs. 1,00,000/- to the petitioner. The court also directed the State Government to provide necessary medical equipments to all the hospitals run by the State Government where laparoscopic tubectomy operations are conducted.
Arun Madan, J.-This order will dispose of the above application for compliance of order, dated 22-9-1989 passed by this Court in S. B. Civil Writ Petition No. 3967/1989 filed by the applicant-petitioner. This Court while disposing of the writ petition allowed the same in terms of its order, dated 22-9-1989 with the direction to the State Government for conducting thorough inquiry into the matter and the circumstances resulting in the death of the petitioner’s wife Smt. Lalitabai while she was being operated for Laproscopic Tubectomy on 2nd April, 1989 at Primary Health Centre, Gangapurcity, District Sawaimadhopur. This Court had also directed vide the said order that a high level inquiry to be initiated into the matter so as to ascertain the cause of death of Smt. Lalitabai and to fix the responsibility for negligence, if any, on the concerned Doctor. It was further directed that if the circumstances leading to the death of the petitioner’s wife were accidental on account of carelessness and negligence on the part of the Doctor then appropriate compensation shall be paid by the State Government to the petitioner within two months from the said date.
2. Pursuant to the above directions of this Court an inquiry was conducted into the matter by the Enquiry Committee constituted by the State Government. The said Enquiry Committee submitted its report to the State Government on 15-7-1992. The conclusions as well as the recommendations of the said Committee mentioned in the inquiry report are self -explanatory containing startling revelations which are as under:--“CONCLUSIONS:
1. Death was caused by neurogenie shock resulting in cardiac arrest, caused by insertion of pneumo peritoneal needle. This, while rare, is not unknown.
2. Dr. C. P. Gupta does not appear to have been intoxicated while operating,
3. Without proof , to the contrary, we are inclined to accept the doctor’s statement that he did not leave the hospital after giving premedication injections,
4. While the death of the patient was extremely unfortunate, there does not appear to be any wilful negligence on the part of Dr. C. P. Gupta who besides being M. S. in Gynaecology, appears competent and has performed 10-12 thousand laproscopic sterilizations in the past, according to his statement.” “RECOMMENDATIONS:
1. We are given to understand that only 64 deaths have occurred since 1980 while laproscopic tubectomy operations numbering approximately 2 lacs are being done every year. This does not appear to be an unreasonable number. Since the number of deaths is only 64, and since the nature of the operation is extremely sensitive, one feels that substantial compensation should be given to the husband of deceased Smt. Lalita Bai, who has three small children to support and has lost his life-partner, who was a substantial income earner.
2. While cardiac arrest due to pneumo peritoneal needle insertion is rare but not unknown, we feel that the life of the patient could have been saved if adequate resuscitative facilities e.g. Endotracheal anaesthesic, defibrillator and cardiac monitoring equipment had been available. Since every human life is equal, we feel that whenever laproscopic tubectomy is being done whether in a major hospital or in smaller hospitals or in a laproscopic tubectomy Camp, a trained anesthetist with M. S. degree in anesthesiology, and the above mentioned equipment should be available. This should be mandatory for every laproscopic tubectomy operation, in view of the sensitive nature of the operation and the fact that the patient is young, disease free and healthy. Other than the lack of the above mentioned resuscitative equipment and trained anesthetist, we find no evidence to doubt the competence or integrity or efforts made by Dr. C. P. Gupta.”
3. A perusalof the inquiry report itself reveals that if the adequate safeguards by making necessary equipments as suggested by the Committee were made available to the concerned Doctor who had conducted th
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