A botched operation by itself does not constitute medical negligence: SC | Latest news from India

The Supreme Court emphasized that medical professionals cannot be held liable for negligence merely because surgery or treatment did not produce the expected results, stating that doctors’ culpability must arise from clear evidence indicating a deviation from accepted medical practice.

In a decision that emphasized the protection of medical professionals against allegations of negligence, the court emphasized that complications, even unexpected ones, do not necessarily mean that the doctor did not perform his duties with due diligence and skill.

“Simply because the patient did not respond favorably to the surgery or treatment prescribed by the physician, or because the operation was unsuccessful, the physician cannot be held liable for medical negligence immediately by applying the doctrine of Res Ipsa Loquitur (Latin term , meaning “the case speaks for itself”) unless it is established by evidence that the doctor failed to exercise due skill in the performance of his duties,” said a bench of Justices PS Narasimha and Pankaj Mittal .

The principle of “Res Ipsa Loquitur” assumes that negligence is so obvious that it does not require further proof.

The court believes that a bad result does not necessarily mean negligence. Rejecting the suggestion that a botched operation or an unsatisfactory medical outcome inherently indicates negligence, the court emphasized that medical procedures involve inherent risks, and the unpredictability of outcomes should not automatically lead to an inference of negligence.

The case at issue involved a complaint of medical negligence during minor eye surgery on a child diagnosed with congenital ptosis, a condition characterized by drooping of the upper eyelid. The operation was performed by a qualified ophthalmologist at the Post Graduate Institute of Education and Research (PGI), Chandigarh in June 1996. When the operation did not bring the expected improvement and the child’s condition appeared to deteriorate, the patient’s family filed a complaint seeking compensation for what they claimed was poor medical care.

Initially, the State Consumer Commission rejected the complaint, finding no evidence of negligence. The National Consumer Disputes Redressal Commission (NCDRC) set aside the decision, awarding compensation of Rs. ₹3.5 lakh to the complainants and making the doctor and PGI jointly liable. Subsequently, the case reached the Supreme Court, which took a different position, ultimately acquitting the doctor and the medical institution.

A key aspect of the court’s analysis was its reaffirmation of the Bolam test, a standard long recognized in medical negligence cases. Based on the 1957 English case of Bolam Vs Friern Hospital Management Committee, this test states that a doctor is not negligent if he acts in accordance with the practice accepted by a responsible body of medical professionals. In the Indian context, the court endorsed the Bolam test in Jacob Mathews v State of Punjab (2005), holding that only if the doctor lacks the necessary skills or fails to exercise reasonable competence should liability be imposed.

In this case, the court applied this well-established standard, concluding that the attending physician had the necessary qualifications and experience to perform the operation. He added that there was no evidence that the doctor failed to exercise due care or deviated from acceptable medical standards. The court concluded that complications after surgery did not indicate medical negligence.

The decision clarified three important components necessary to establish medical negligence: the medical worker’s duty to care for the patient; a violation in which the doctor’s actions do not meet the expected standard, and indirect damage directly related to this.

In the absence of clear evidence of negligence, the court stated that the unsuccessful result cannot be interpreted as a failure to fulfill duties. It was recognized that complications can occur even with the best medical practice, and that the physician should not be unfairly penalized for rare or disappointing results.

“Deterioration of a patient’s condition after an operation does not necessarily indicate that the operation performed or the treatment given to the patient was improper or inappropriate, or that some negligence was committed during their performance. In the case of surgery or such treatment, it is not necessary that in every case the patient’s condition improves and the operation is successful to the satisfaction of the patient,” the decision reads.

When a patient is properly cared for, the judge said, evidence to the contrary must be presented to arrest medical professionals for negligence, which is the cause of criminal proceedings.

The verdict has significant implications for medical professionals, offering them protection from wrongful liability if they have followed established medical practice and exercised due care, even as it seeks to balance patients’ rights with protecting doctors from wrongful prosecution.