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2025 Supreme(Online)(SCDRC) 5084
STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Sangita Dhingra Sehgal, President, Pinki, Judicial Member
Dharmesh Jain – Appellant
Versus
Pawan Gupta – Respondent
FIRST APPEAL NO.-455/2023
For the Appellants/Petitioners: Kapil Kher, Mohd. Irshad
For the Respondents: Bharat Bhushan Dhingra, S.C. Bhuttan, Nikhil, Maibam N Singh
Medical professionals owe a duty of care to follow established dosage protocols. Administering an excessive drug dose resulting in foreseeable injury or death constitutes medical negligence, particularly where records contain suspicious interpolations and the adverse clinical outcome is directly attributable to the breach of standard treatment guidelines.
Headnote:(A) Consumer Protection Act, 1986 - Section 2(1)(g) - Deficiency in service - Medical Negligence - Allegation of fatal drug overdose - Standard of care - Duty of medical professionals to adhere to prescribed dosage protocols - Burden of proof in medical negligence cases - Application of Res Ipsa Loquitur in cases of inexplicable overdose resulting in death. (Paras 14, 18, 21)
(B) Appeals - Scope of appellate review - Appellate authority to evaluate evidence and determine if the lower forum correctly applied legal principles and medical literature to the facts of the case - Misconduct occurs when medical records are found to contain deliberate interpolations or clear deviations from established safety standards. (Paras 10, 11, 16)
Facts of the case:
A patient was admitted to a hospital with a diagnosis of bacterial meningitis. The complainant alleged that the medical practitioners administered a toxic and excessive dose of a common antibiotic, far exceeding the standard clinical guidelines. This alleged overdose purportedly led to recurrent seizures, necessitated the use of multiple anti-epileptic drugs, triggered respiratory failure, and eventually caused the patient's death. The hospital argued that the prescribed dosage was within acceptable limits and that the higher figure in the records was an inadvertent clerical error.
Findings of Court:
The court observed glaring interpolations in the records where doses were overwritten. It found that even the lower reported dose exceeded the standard therapeutic range recommended by medical literature. Following the principle that a medical professional must exercise reasonable care, the court noted that the overdose directly correlated with the patient's subsequent seizure activity and fatality.
Issues: The main issues were whether the hospital and attending staff were guilty of medical negligence due to drug overdose, whether the records were tampered with, and if the 'but for' test of causation was satisfied.
Ratio Decidendi: The court held that medical professionals are bound to follow standard treatment protocols and dosage guidelines. When records show inexplicable high dosages and clinical outcomes indicate toxic reactions known to be caused by that specific drug, the onus shifts to the medical practitioners to explain the deviation. Failure to provide such justification, paired with evidence of record tampering, constitutes medical negligence.
Result: Appeal dismissed.
| Table of Content |
|---|
| 1. dismissal of interlocutory application regarding compliance of section 41 and review of delay condonation. (Para 1 , 2) |
| 2. summary of factual allegations regarding medical negligence, drug dosage disputes, and procedural history. (Para 3 , 4) |
| 3. appellate court review affirming the finding of medication overdose as medical negligence. (Para 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20) |
JUDGMENT
1. By this judgment, we shall dispose off the present Appeal as well as an application filed by the Respondent No.1 under section 41 & 50 of the Consumer Protection Act, whereby the Respondent No.1 has prayed for review of the order dated 18.09.2023 vide which the delay in filing the Appeal was condoned subject to condition of depositing Rs.10,000/- with the Delhi State Legal Services Authority. However, in the application a contrary prayer has been sought which is as follows :
“It is, therefore, most humbly prayed that the present appeal may kindly not be entertained and heard till the compliance of the provisions of Section 41 of the Act and deposit of 50% of the award amount by the appellants. The applicant respondent no.1 also most humbly prays for review and recall of the said order dated 18.09.2023 to meet the ends of justice and delay in filling the present application may also be condoned in the interest of justice. Any other or further relief which this Hon'ble Commission may deems fit and proper be also granted in favour of the applicant-respondent no.1.”
2. The aforesaid prayer clause further reflects that the Respondent has prayed that the present Appeal not be entertained since the Appellants have not deposited 50% of the award in compliance of section 41 of the Consumer Protection Act. A perusal of the record shows that the Appellant has deposited a sum of Rs.25,000/- in the form of an FDR, as the case in hand pertains to the Old Act i.e. the Consumer Protection Act, 1986, in view of the judgment passed by the Hon’ble Apex Court in Neena Aneja V. Jai Prakash Associates Ltd reported as AIR 2021 SC 1441, the Appeal proceedings shall be deemed to continue under the provisions of the Old Act only. Thus, in our view the condition precedent for filing the appeal has been fulfilled by the Appellant rendering the prayer in the aforesaid application infructuous. Accordingly, the present Application stands dismissed.
3. Now we shall proceed to deal with the Appeal on merit. The facts of the case as per the District Commission record are as under:
“…1. Facts germane for disposal of the present complaint are that Complainant is husband of the deceased Smt. Krishna Gupta aged about 53 years (at the time of death) whose death at OP 1 hospital has given rise to the present complaint of alleged medical negligence. Complainant's deceased wife was a diabetic but was on regular treatment and in controlled condition for last 5-6 years (till her death filing of the present complainant). On 01-11-2007, she complained of severe headache & was admitted to OP 1 hospital on 02-11-2007 in CCU ward Bed No. 2 vide admission no. 87662. Her NCCT head scan report revealed small right ganglionic bleed without mass effect and on her medical examination done by OP 2, she was referred to the Neurology Department from Casualty of OP 1 where she was earlier checked by OP 3 when she was brought in unconscious state and pupils constricted not reacting to light. MRI Brain as advised was conducted which ruled out ganglionic bleed but probable diagnosis of meningitis was made by OP 4. After some time OP 2 did a lumbar puncture test on the complainant's wife and sent her Cerebral Spinal Fluid (CSF) sample for examination. She was diagnosed with Acute Pyogenic Meningitis (APM) and was put on antibiotics and medications through IV including Injection Crystalline Penicillin 80 lacs units I/V x 3 hourly which comes to about 64 million units per day. The complainant had alleged that because of toxic dose of penicillin given
