Supreme Court of India orders ₹ 1.8 Crore compensation in Medical Negligence Case

New Delhi: A ruling by the Supreme Court of India in a medical negligence case has ordered a compensation of ₹1.8 Crore to be paid to the petitioner. The compensation counts as one of the largest in the country so far. The sum has to be paid by the Tamil Nadu government to an 18-year-old girl who lost her vision at birth due to medical negligence at a government run hospital.

The 18-year-old girl was born prematurely in a government run hospital in Egmore, Chennai. The case of medical negligence occurred when she was discharged without the compulsory retinopathy test to be done for premature babies. The girl had already lost her vision by the time the family learned of the error.

Following the incident, the girl’s father approached the National Consumer Forum, which granted a compensation of ₹ 5 lakhs. Discontented with the sum, the family then took the matter to the SC.The Tamil Nadu government had challenged the Consumer Forum’s decision. But the ruling by SC today dismissed the state government’s appeal and also ordered it to pay the larger compensation.

“Justice has prevailed after a legal battle of 18 years”, the girl’s father Mr. Krishna Kumar said.

Is this the right way to go?

 But the question is, has justice really prevailed for the society at large? Are rulings similar to this one benefitting the healthcare scene in India? The answer does not look too bright.

Dr. Devi Shetty, the eminent cardiac surgeon and Chairman of Narayana Health has for long held the beacon in an effort to spread awareness on the disastrous scenarios for healthcare if a cap is not fixed in medical negligence cases. According to him “There should be a strong law to regulate the way doctors practice, and if there is malpractice, punish, even revoke the doctor’s license.” “But the compensation should be capped as in the US and Europe or else it would aggregate the existing shortage of medical professionals, besides pushing up costs”, he added.

In the present India, not one day passes without a court case being filed against a medical professional (usually a doctor) or a medical institution. It has become a norm for the doctor to be blamed even for factors that are not within his control. These litigations often end up with the medical institutions or individual doctors having to pay hugely inappropriate compensations. To add to that, the law does not allow the healthcare providers to even file a review petition.

In October last year, the Supreme Court directed Kolkata-based AMRI Hospital and three of its doctors to pay Rs. 6 crore (up to Rs. 11 crore, including interest) to non-resident Indian doctor Kunal Saha, following the death of his wife. This was the country’s highest compensation for medical negligence.

The incident left doctors around the country concerned and anxious. Earlier this year, the Association of Healthcare Providers of India and the Indian Medical Association decided to approach the Health Ministry, urging it to request the Law Ministry to cap malpractice compensation. But there has been no result as yet.

The US Story

In the early 90s, malpractice compensation reached gigantic proportions. As a consequence, malpractice insurance premiums also rose, to three months of doctors’ salary. This was met with a major strike from doctors, when they decided to stop deliveries in small towns in the US.

The government had to resort to the risky and unsustainable measure of airlifting pregnant women to city centers during childbirth. So several states in the US capped malpractice compensation at $250,000 (Rs 1.5 crore). This cap reduced malpractice suits considerably. Several European countries also cap malpractice compensation to protect the interests of patients and citizens. Even in India, compensation caps exist in several sectors. For example, government officers cannot be fined more than a third of their basic monthly salary.

The side effect

 “I think it is slightly unreasonable. Mistakes do happen. It was very unfortunate but there should be a reasonable cap as to how much should be given,” says a young doctor from Bangalore, who prefers not to be named.

“We will be scared to enter super-specialty as this area is most affected by this kind of compensation,” she adds.

Negligent doctors should be punished financially but not to the extent that it results in bankruptcy. Serious financial hardship will encourage doctors to practice defensive medicine and discourage young people from choosing the profession.

Implementing “first world regulatory structures with third world infrastructure,” has its pit-falls, said Dr. Shetty, as India is “short of one million doctors, two million nurses and three million beds.”

In small towns, for instance, gynaecologists could stop delivering babies, fearing litigation. In the event of an unfortunate incident, if a patient sues for Rs. 2 crore – “even if he (gynaecologist) sells his nursing home, his house and farmland, if he has any, will still not be able to come up with ₹2 crore,” he added. No amount of money can compensate the loss of a loved one, but the best punishment for errant doctors would be to disallow them from practicing, he pointed out. Discouraging doctors from practicing will put the lives of thousands of people at risk.“Healthcare comes under the purview of the consumer courts, which may not be best placed to judge the quality of complex medical care. Rather, the ministry of health should convene a committee with representatives of doctors and civil society to decide the maximum compensation for malpractice”, suggests Dr. Shetty.

Every life counts. The loss of a loved one cannot fully be compensated any amount of money. Medical malpractice certainly deserves punishment and doctors must be prevented from neglecting patients. But how much can we afford? The government and the Ministry of Law need to urgently look into this and come up with a solution that is apt for our healthcare system.

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