In a case involving a Nasotracheal Intubation, where it was alleged that it resulted in a number of serious medical issues, a Supreme Court bench composed of Justices Hrishikesh Roy and Manoj Misra dismissed a claim of medical negligence and set aside the compensation given.

In this regard, the Court stated, “This is a classic case of human fallibility where the doctors endeavoured to do the best for the patient based on their experience and evolving situations. The intended outcomes, though, were not realised. It is not possible to say for sure that there was medical negligence involved in the current situation after looking at the course of treatment.

In this instance, civil appeals under Section 23 of the Consumer Protection Act of 1986 were filed in order to contest an NCDRC (National Consumer Disputes Redressal Commission) ruling. The NCDRC has ordered Mrs. Sunita Parvate to receive Rs. 6,11,638 in damages from Suretech Hospital, Drs. Nirmal Jaiswal, Madhusudan Shendre, and M.A. Biviji for medical malpractice. The case involved Mrs. Sunita undergoing a forceful Nasotracheal Intubation (NI) surgery, which led to a number of serious medical issues, including tracheal injury, infection, and voice loss. The NCDRC found inadequate support for Mrs. Sunita’s assertions that her septicemia and thrombocytopenia were caused by the carelessness, despite her claims. It did come to the conclusion that the Tracheostomy Tube (TT) replacement forced NI surgery was unnecessary. In light of the NCDRC’s conclusion that this act of negligence caused direct tracheal damage, compensation for medical expenses spent at Suretech Hospital was granted. Mrs. Sunita then filed an appeal for more money and a higher interest rate, but Dr. M.A. Biviji, Suretech Hospital, and the other doctors refuted the allegations of negligence, claiming that the forced NI procedure could not be solely blamed for the complications that followed.

The Apex Court observed that since the patient was treated and underwent different procedures at multiple hospitals, there was a possibility that the medical complications could have arose at any of the hospitals or places of treatment. Further, it was held that there was no substance to establish the causal link between the ‘NI’ procedure that was undertaken at Suretech Hospital and the subsequent medical complications that arose. In that context, it was said that, “It must be pointed out that the only medical report available in this case i.e., the RML Hospital Committee Report did not attribute any negligence to Suretech Hospital, Dr. Biviji, Dr. Jaiswal or Dr. Shendre with respect to any of the charges levelled against them. If the ‘NI’ procedure had been conducted in a negligent manner or was a poor medical decision, it is likely that the RML Hospital Committee Report would have mentioned the same. However, no such observation was made either. Further, none of the doctors that treated the patient commented adversely with respect to the chosen course of treatment.”

It was further observed that there was nothing to say that the procedure conducted was outdated or poor medical practice. In that vein, it was observed that, “the medical team at Suretech Hospital has been able to show that the ‘NI’ procedure was carried out on 13.05.2004 only after due consideration. The existing ‘TT’ was removed after the bronchoscopy showed normalcy in the airways & trachea of the patient. It was expected that the patient would be able to breathe normally without any support after ‘TT’ decannulation. However, a stridor was observed in the airways of the patient, after the said decannulation took place. In light of the same, an alternative course of treatment in the form of an ‘NI’ procedure was opted for as a temporary measure.”

Resultantly, the appeal was dismissed, and the parties were left to bear their own costs. The impugned judgment awarding compensation on account of medical negligence was set aside.

Case Title: M.A Biviji vs Sunita & Ors.