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Synopsis

The Supreme Court has said the principle of 'Res Ipsa Locutor' could be applied in a case where there is strong incriminating circumstances or documentary evidence of negligence are available.

A bench of Justices A S Bopanna and Prashant Kumar Mishra has thus dismissed an appeal filed by Kalyani Ranjan, whose 37-year-old husband Sankar Rajan, died on November 06, 1998 of heart attack, allegedly due to negligence by the doctors at Indraprastha Apollo Hospital here after a major neurosurgery.

Ranjan claimed the deceased was operated upon October 29, 1998 and was shifted to a private room. He suffered unbearable neck pain and doctors were contacted but he suffered heat attack at about 11 pm. He was declared brain dead on October 31 and kept on life support till his death on November 6, 1998.

She raised the grievance that the deceased was not attended to by any doctor from neurosurgery team who had operated the deceased after he was shifted into the private room till 11.00 P.M. After such major surgery, instead of shifting to a private room, the deceased should have been shifted to the Intensive Care Unit. She said the deceased died due to cardiac arrest, albeit, admittedly, the deceased had no cardiac problems. 

The appellant relied upon the principle of 'Res Ipsa Locutor' to attribute negligence to the hospital and doctors.

The bench, however, said, "There is no evidence put forth by the complainant to establish that heart attack suffered by the patient had any connection with the operation in question or that it was on account of negligent post operative care."

It also pointed out the patient did not have any history of diabetes or hypertension or any cardiac problem. "Therefore, it was difficult for treating doctors including the duty doctor or the hospital to assume that the patient may suffer cardiac arrest and moreover, the patient had also not complained of pain in any other part of the body except neck region," the bench said.

"In so far as the applicability of principles of Res Ipsa Locutor, in the fact and circumstances of the case, it is to bear in mind that the principles get attracted where circumstances strongly suggest partaking in negligent behaviour by the person against whom an accusation of negligence is made. For applying the principles of Res Ipsa Locutor, it is necessary that a ‘Res’ is present to establish the allegation of negligence. Strong incriminating circumstantial or documentary evidence is required for application of the doctrine," the bench explained.

The court further said the case in hand stands on a better footing, in as much as there was no mistake in diagnosis or a negligent diagnosis by the doctor. 

"In the absence of the patient having any history of diabetes, hypertension, or cardiac problem, it is difficult to foresee a possible cardiac problem only because the patient had suffered pain in the neck region," the bench reiterated.

The bench upheld the order by the National Consumer Disputes Redressal Commission --rejecting the appellant's complaint -- saying it does not suffer from any illegality or perversity as she failed to establish any negligence on the part of the hospital or doctors in taking post operative care.

The hospital and doctors had also filed affidavit of Prof Gulshan Kumar Ahuja, professor of neurosurgery in AIIMS and Senior Consultant in Neurology, who after going through the record and CT Scan had opined that the record did not show any abnormality at the operated site and the complications suffered by the patient were totally unrelated to the surgery and that that pain in the neck along with sweating and nausea are not the symptoms of cardiac respiratory arrest. 

Apollo also furnished the figures stating during the months of September to November 1998, out of 166 neurosurgeries, only 68 patients were sent to the ICU from the recovery room and the rest were sent back to their wards.

Case Title: Mrs Kalyani Ranjan Vs Indraprastha Apollo Hospital & Ors