|In the Supreme Court of India|
|Case Name||Laxman Balkrishna Joshi vs Dr.Trimbak Bapu Godbole|
|Citation||AIR 1969 SC 128|
|Date of Judgement||2 May 1968|
|Appellant||Laxman Balkrishna Joshi|
|Defendant||Dr.Trimbak Bapu Godbole|
|Bench||3(JUSTICE; SHELAT, J.M; BACHAWAT, R.S.; GROVER, A.N.)|
|Important Provision||Fatal Accidents Act (XIII of 1855)|
The concept of Medical Negligence finds its place in the ‘Code of Hammurabi’ which was developed by Babylon’s Kings some 20 centuries before the Christian era and includes fees for treatment and penalties for improper treatment. The ‘Law of Talion’ by Israelites evolved ‘an eye for an eye, a tooth for a tooth’. Ancient Egyptian law provided for the negligent healer’s banishment or death. Roman civil law was designed to punish medical wrongdoers so also the Medieval law was equally hard on errant ‘barbers and surgeons’.
The Manusmriti advocates the payment of a fine. The concept of damages for medical negligence varied based on the severity of injury or loss of life and even in cases of the growth of the disease due to negligence or indifference.
Medical negligence emerges from an action or negligence by a medical practitioner, which no rationally capable and diligent medical practitioner would have performed.
Consequently, a medical practitioner is presumed to adopt rationally skillful conduct and follow the standard skills and practices of the medical profession with expected care while attending/ treating the patient. Physicians who act improperly are liable to punishment and the quantum of the penalty varies according to the status of the victim.
Facts of the Case
- On May 6, 1953, Ananda, the son of the respondent who aged about twenty years, met with an accident on the sea beach at Palshet, a village in Ratnagiri District, which resulted in the fracture of the femur of his left leg.
- Since the sea beach was at a distance of 14′ miles from the place where he and his mother lived at the time it took some time to bring a cot and remove him to the house.
- Dr. Risbud, a local physician, was called at about 8-30 or 8-45 p.m. The only treatment he gave was to tie wooden planks on the boy’s leg to immobilize it and give rest. The next day, he visited the boy and though he found him in good condition, he advised his removal to Poona for treatment.
- On May 8, 1953, Dr. Risbud procured Mae Intyres splints and substituted them for the said wooden planks. A taxi was thereafter called in which the boy Ananda was placed in a reclining position and he, along with respondent 2 and Dr. Risbud, started for Poona at about 1 A.m.
- They reached the city after a journey of about 200 miles at about 11-30 A.m. on May 9, 1953. By that time respondent, 1 had come to Poona from Dhond where he was practicing as a medical practitioner.
- They took the boy first to Tarachand Hospital where his injured leg was screened. It was found that he had an overlapping fracture of the femur which required pin- traction. The respondents thereafter took the boy to the appellant’s hospital where, in his absence, his assistant, Dr. Irani, admitted him at 2:15 p.m.
- Sometime thereafter the appellant arrived and after a preliminary examination directed Dr. Irani to give two injections of 1/8th grain of morphia and 1/200th grain of Hyoscine H.B. at an hour’s interval.
- Dr. Irani, however, gave only one injection. Ananda was thereafter removed to the X-ray room on the ground floor of the hospital where two X-ray photos of the injured leg were taken. He was then removed to the operation theatre on the upper floor where the injured leg was put into plaster splints.
- The boy was kept in the operation theatre for a little more than an hour and at about 5-30 P.m., after the treatment was over, he was removed to the room assigned to him. On an assurance given to respondent 1 that Ananda would be out of the effect of morphia by 7 P.m., respondent 1 left for Dhond.
- Respondent 2, however, remained with Ananda in the said room. At about 6-30 p.m. she noticed that he was finding difficulty in breathing and was having a cough. Thereupon Dr. Irani called the appellant who, finding that the boy’s condition was deteriorating started giving emergency treatment which continued right until 9 P.m. when the boy expired.
- The appellant thereupon issued a certificate, Ext. 138, stating therein that the cause of death was fat embolism.
Whether the doctor will be held liable for their negligence while treating the patient?
Section 3 of the Fatal Accident Act, 1855.
“The defendant did not perform the essential preliminary examination of the boy before starting his treatment; that without such preliminary examination a morphia injection was given to him; that the boy soon after went ‘under morphia’ that while he was ‘under morphia’ the appellant took him to the X-ray room, took X-ray plates of the injured leg and removed him to the operation theatre.
Their case further was that “While putting the leg in plaster the defendant used manual traction and used excessive force for this purpose, with the help of three men although such traction is never done under morphia alone, but done under proper general anesthesia.
This kind of rough manipulation is calculated to cause conditions favorable for embolism or shock and prove fatal to the patient.”
“The defendant did not find it desirable to give a general anesthetic. The defendant, therefore, decided to immobilize the fractured femur by plaster of Paris bandages.
The defendant accordingly reduced the rotational deformity and held the limb in proper position with slight traction and immobilized it in plaster spica. The hospital staff was in attendance. The patient was cooperating satisfactorily.
The allegation that the defendant used excessive force with the help of three men for manual traction is altogether false and mischievous and the defendant does not admit it.”
Supreme Court favors the decision of the High Court and Trial Court. The trial court and the High Court were, therefore, right in holding that the appellant was guilty of negligence and wrongful acts towards the patient and was liable for damages. They held:
“The duties which a doctor owes to his patient are clear. A person who holds himself out ready to give medical advice and treatment impliedly undertakes that he is possessed of skill and knowledge for the purpose. Such a person when consulted by a patient owes him certain duties viz., a duty of care in deciding whether to undertake the case, a duty of care in deciding what treatment to give, or a duty of care in the administration of that treatment. A breach of any of those duties gives a right of action for negligence to the patient. The practitioner must bring to his task a reasonable degree of skill and knowledge and must exercise a reasonable degree of care. Neither the very highest nor very low degree of care and competence judged in the light of the particular circumstances of each case is what the law requires.”
It was laid down that when a doctor is consulted by a patient, the doctor owes to his patient certain duties which are:
(a) Duty of care in deciding whether to undertake the case,
(b) Duty of care in deciding what treatment to give, and
(c) Duty of care in the administration of that treatment.
A breach of any of the above duties may give a cause of action for negligence and the patient may on that basis recover damages from his doctor.