Max Hospital and Doctor Ordered to Pay ₹10 Lakh for Negligence After Patient's Death, Cites Lack of Informed Consent

Dehradun, Consumer State Commission: The Consumer State Commission has held Max Super Speciality Hospital, Dehradun, and one of its doctors jointly and severally liable for medical negligence, ordering them to pay ₹10 lakh in compensation to the family of a patient who died after a pre-operative cardiac test went wrong. The commission, presided over by Ms. Kumkum Rani and Mr. C.M. Singh, found a critical failure to obtain informed consent before the procedure, which it deemed a significant deficiency in service.

Background of the Case

The complaint was filed by Sh. Sandeep Gupta, whose mother, the late Smt. Shakuntala Devi, was admitted to Max Hospital in April 2014 for a proposed surgery to treat facial pain. As part of the pre-operative evaluation, cardiologists recommended a Dobutamine Stress Echo (DSE) test to assess her cardiac fitness.

On April 12, 2014, Dr. Amit Rana performed the DSE test. During the procedure, Smt. Devi suffered a cardiac arrest, became unresponsive, and was shifted to the ICU. She remained in a vegetative state from that day forward. After being billed over ₹5.6 lakh, she was discharged on May 9, 2014, and subsequently passed away at another hospital on May 13, 2014.

Arguments from Both Sides

Complainant's Arguments: Sh. Gupta, through his counsel, argued that Dr. Rana was negligent in conducting the DSE test. He alleged that the procedure was performed without explaining the associated risks and without proper monitoring of the drug infusion. The complainant contended that the consent obtained was merely a formality and not truly "informed." It was further alleged that the hospital, despite its super-specialty status, had an inadequate emergency response and had misled the family on treatment costs.

Hospital's Defense: The hospital and its doctors jointly denied all allegations. They maintained that the DSE test was medically necessary given the patient's history of hypertension, obesity, and restricted mobility. Their counsel asserted that informed consent, explicitly mentioning the risk of cardiac arrest, was duly obtained. They claimed that an immediate "Code Blue" was declared following the cardiac arrest and all standard emergency protocols (ACLS) were followed by a competent team in a fully equipped facility.

Court's Findings and Reasoning

The commission focused on the central question of whether there was negligence in conducting the DSE test and providing subsequent medical care.

The judgment's pivotal finding was the complete absence of proof of informed consent. The commission noted:

> "Upon perusal of the record, it is evident that the opposite party Nos. 1 to 5 have not produced any material to establish that a consent was obtained from the patient or her attendants prior to undertaking DSE test. There is no specific consent form showing details of nature of the procedure, its risks, complications nor there is any record demonstrating that such information was ever explained..."

This failure, the commission concluded, amounted to a "deficiency in service and constitute[d] negligence" on the part of the performing doctor.

Principle of Vicarious Liability Applied

While Dr. Amit Rana (Opposite Party No. 5) was held primarily responsible for the negligent act, the commission extended liability to Max Hospital (Opposite Party No. 1) under the principle of vicarious liability. Citing the Supreme Court's decision in Maharaja Agrasen Hospital & Ors. vs. Master Rishabh Sharma & Ors. , the commission affirmed that a hospital is liable for the negligent acts of doctors employed by it.

The court exonerated the three other doctors involved (Opposite Parties No. 2, 3, and 4), finding no evidence of independent negligence on their part as they were merely consulting and referring physicians who did not participate in the DSE test.

The Final Verdict

The consumer complaint was partly allowed. The commission directed Max Super Speciality Hospital to pay a total compensation of ₹10 lakh to the deceased's legal heirs. This amount includes medical expenses incurred by the family. Additionally, the hospital was ordered to pay litigation costs of ₹50,000/- . The entire sum is to be paid with a simple interest of 6% per annum from the date the complaint was filed (July 22, 2014) until the date of actual payment.