MUMBAI: There are times when a doctor’s diagnosis turns out to be incorrect. Wrong diagnosis may or may not constitute negligence , but the patient usually jumps to the conclusion that the doctor has been negligent. Filing a case on the basis of a presumption causes heartburn to the patient as well as the doctor; while the patient loses money in litigation, the doctor is put through harassment to defend self, despite having done nothing wrong.

Case Study: Badam Jyothi, down with fever, was brought to Pavan Nursing Home run by Dr Reddy. The doctor diagnosed her with dengue and admitted her. She was treated for six days. Though medicines were given and tests conducted, her condition deteriorated and she lost consciousness. Her family said they wanted to shift her to a better hospital, but that the doctor did not agree. When the family insisted, the doctor referred Jyothi to Rohini Hospital, where she was diagnosed with cerebral malaria. She was treated for 10 days at an expense of over Rs 1 lakh, but her condition did not improve. Rohini Hospital doctors advised her to be shifted to a hospital in Hyderabad, but she died on the way due to multiple organ failure.

Jyothi’s husband and sons filed a complaint against Dr Reddy before the Warangal district forum, alleging death due to medical negligence. They claimed that a platelet count test was performed to check for dengue, but a blood smear test for malaria was not done. So malaria remained undiagnosed and by the time Jyothi was shifted to Rohini Hospital, irreversible damage had been done. They claimed Rs 10 lakh as compensation.

The doctor contested and claimed that Jyothi was treated on OPD basis for two days and then admitted for four days. Relevant test had been conducted and medicines were correctly administered. Dr Reddy said on the basis of clinical examination, test reports, and several reported cases of dengue, he suspected Jyothi to be suffering from viral infection and dengue. He produced medical literature and showed Jyothi had not exhibited any symptoms of Falciparum/cerebral Malaria. The doctor said the family had never made a request for shifting the patient. On the contrary, Dr Reddy said he had advised to shift Jyothi to a better-equipped hospital.

The district forum held Dr Reddy guilty and ordered him to pay Rs 5 lakh. The doctor appealed to the Andhra Pradesh State Commission , which reduced the compensation to Rs 1 lakh. The doctor and the Badam family then approached the National Commission in revision. The commission noted that Jyothi’s condition was already bad when she was admitted under Dr Reddy. The doctor had attended on the patient and acted with ordinary skill and competence. The failure to detect cerebral malaria might be an error of judgment, but would not constitute negligence. The commission noted that the Andhra Pradesh Medical Council had inquired and had concluded that Dr Reddy had not been negligent while treating Jyothi. Accordingly, in its May 23 judgment, the commission allowed the doctor’s plea and dismissed the complaint.

Conclusion: Patients must understand medicine is not an exact science. A doctor can be held negligent only if s/he does not exercise ordinary skill and prudence as expected of a reasonable professional.

( The author is a consumer activist and has won the government India’s national youth award for consumer protection.)

