Pranav B Prem

The Delhi High Court has observed that medical negligence cannot be established by mere dissatisfaction or the assertion of an 'expected standard of care', rather it must be demonstrated that the doctor's conduct fell below the level of a reasonably competent practitioner in similar circumstances.

Justice Sanjeev Narula, while delivering the judgment, emphasized, “The proper criterion for determining medical negligence lies in assessing whether the actions of the doctor fall below the accepted standards of a reasonably competent practitioner within the relevant field.”

Case Background

The case arose from a writ petition filed by Shiv Kumar, who alleged medical negligence and misconduct against doctors at Max Super Speciality Hospital, Delhi, following the death of his wife. She had been diagnosed with Systemic Lupus Erythematosus (SLE) and Hematemesis and required urgent critical care. The petitioner claimed that lapses in treatment, delays in performing tests, and inappropriate administration of drugs, particularly the infusion of Fentanyl, led to her untimely demise.

Proceedings Before Medical Bodies

The Delhi Medical Council (DMC) initially found two junior doctors guilty of professional negligence, issuing warnings and directing them to undergo emergency medicine training. However, no action was taken against the other respondent doctors. Dissatisfied, the petitioner escalated the matter to the National Medical Commission (NMC), which, after a detailed review, concluded that there was no sufficient evidence of medical negligence by the respondent doctors. The petitioner challenged the NMC’s order before the High Court, asserting that the doctors had failed to meet the standard of care required in such critical circumstances.

Key Allegations and Court's Observations

One of the petitioner's primary allegations was that the excessive infusion of 850 mcg of Fentanyl in a short timeframe amounted to reckless behavior, effectively poisoning the patient. The Court, however, upheld the NMC’s findings, stating that the dosage and administration of such drugs fall squarely within the expertise of medical professionals. Justice Narula remarked, “The Court, lacking medical expertise, must trust the domain knowledge of qualified professionals, especially when the decision is the product of a recognized peer-review mechanism. Judicial interference in such cases would be unwarranted.”

The Court also addressed other claims of negligence, including delays in ICU admission and diagnostic tests. It noted that the medical records provided by the respondent hospital documented timely interventions, with the patient receiving necessary critical care, including ventilator support, resuscitation, and specialist consultations. Further, the Court highlighted the dynamic nature of ICU admissions and observed that the petitioner’s wife had been appropriately placed in a crash room equipped for critical care when an ICU bed was unavailable.

Court's Findings

The High Court dismissed the petition, highlighting the weight of findings by expert medical bodies like the DMC and NMC. It stated that their determinations, supported by peer reviews, are entitled to significant deference unless shown to be perverse, arbitrary, or illegal.

Justice Narula reiterated that allegations of medical negligence must be substantiated by clear evidence showing a deviation from accepted medical practices. He concluded, “While the Court empathizes with the petitioner’s loss, it cannot substitute its judgment for that of medical experts. The findings of the DMC and NMC clearly indicate that the treatment provided to the petitioner’s wife was appropriate, considering her complex medical condition.” The Court thus did not find any illegality in the NMC's order and dismissed the petition.

Cause Title: SHIV KUMAR V/S NATIONAL MEDICAL COMMISSION & ORS. 

Case No: W.P.(C) 4828/2021 & CM APPL. 18188/2024

Date: December-20-2024

Bench: Justice Sanjeev Narula

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