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M.A. Biviji vs Sunita

Civil Appeal · 2023 INSC 938Decided 19 Oct 2023
Civil Appeal No. 3975 of 2018
Hrishikesh Roy · Manoj Misra

Background

After a serious car accident, a woman was treated at a Gondia hospital and then shifted to Suretech Hospital, Nagpur, where she underwent several breathing-related procedures, including a Nasotracheal Intubation (NI) on 13.05.2004. She later developed voice loss and permanent respiratory tract deformity, and filed a consumer complaint alleging that the doctors and hospital had negligently performed the NI procedure. The National Consumer Disputes Redressal Commission (NCDRC) partly upheld her complaint and awarded compensation against the hospital and three doctors, and cross-appeals were filed both by the doctors/hospital (denying negligence) and by the patient (seeking higher compensation).

Decision Breakdown

The Supreme Court examined the medical records, an expert committee report from RML Hospital, and medical literature, and found that the patient's respiratory complications (subglottic stenosis) are a recognised, not-uncommon risk of prolonged or repeated intubation in accident patients treated across multiple hospitals, not something specifically caused by negligence in the NI procedure. It noted that the medical report did not attribute negligence to any doctor, and that the treating team had followed a reasonable clinical course, choosing NI as a temporary measure only after the earlier tracheostomy tube was found unsuitable. Quoting surgeon-author Atul Gawande on the inherent uncertainty of medicine, the Court held this was a case of an unfortunate outcome despite genuine medical effort, not a breach of the duty of care. It therefore set aside the NCDRC's negligence finding and compensation order, allowing the doctors' and hospital's appeals and dismissing the patient's appeal for enhanced compensation.

Lesson Learnt

A poor or unexpected medical outcome does not by itself prove negligence. Courts require a demonstrated breach of the duty of care and a clear causal link between the specific act complained of and the injury, and expert medical opinion carries significant weight in that assessment.

Official source (sci.gov.in)View Judgment (PDF)

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