The appellant filed an appeal alleging medical negligence, and the division bench of Sanjay Karol and Arvind Kumar, JJ., set aside the challenged orders of the National Consumer Disputes Redressal Commission (the “NCDRC”) and the State Consumer Disputes Redressal Commission (the “State Commission”) and ordered the hospital to reimburse the appellant within four weeks of this judgment for the amount of Rs. 5 lakhs, plus interest at the rate of 9% from the date of the award made by the District Consumer Disputes Redressal Forum (the “District Forum”). The Court also assessed litigation costs of Rs. 50,000/-.

Regarding the eggshell rule, the Court held that the individual in whose case the adjudicatory authority uses this must already have a pre-existing condition in order for the rule to be properly invoked and applied.

 Background:

A senior surgeon operated on the appellant after she was admitted to Suket Hospital in Himachal Pradesh in 2005 to remove her appendix. She was released from the hospital after the procedure, but her discomfort persisted. After that, on July 26, 2005, she was admitted once more, but the next day, she was released from the hospital with the guarantee that she wouldn’t experience any more suffering. But the pain she endured had no end. This was a four-year process that never ended.

Ultimately, the appellant sought treatment at Chandigarh’s Post Graduate Institute of Medical Science. A second surgery was required to remove a 2.5 cm foreign body (needle) that was discovered to be present below the anterior abdominal wall in the preveside region, directly medial to the previous abdominal scar (appendectomy).
The appellant alleged that the hospital had been negligent and sought compensation for the extreme suffering and Rs. 19,80,000/- in medical expenses.

The Hospital was ordered by the State Commission and the District Forum to pay the appellant’s costs as well as her bodily and emotional suffering. In the Revision, the NCDRC increased the State Commission’s award of compensation to Rs. 2,00,000/-. As a result, the appellant favors this current appeal and is asking for more compensation.

 

Analysis:

The Court examined the Scope of the Consumer Protection Act and the law on Medical Negligence.

Determining the ‘compensation’, the Court referred to the concept of ‘just compensation’ , and said that the idea of compensation is based on restitutio in integrum, which means, make good the loss suffered, so far as money is able to do so, or, in other words, take the receiver of such compensation, back to a position, as if the loss/injury suffered by them hadn’t occurred. What qualifies as just compensation must be considered in each case’s facts.

Examining the Eggshell Skull Rule, the Court said that it is a common law doctrine that makes a defendant liable for the plaintiff’s unforeseeable and uncommon reactions to the defendant’s negligent or intentional tort. In simple terms, a person who has an eggshell skull is one who would be more severely impacted by an act, which an otherwise “normal person” would be able to withstand. Hence, the term eggshell denotes this, as an eggshell is by its very nature, brittle. It is otherwise termed as “taking the victim as one finds them” and, therefore, a doer of an act would be liable for the otherwise more severe impact that such an act may have on the victim.

The Court said that the jurisprudence of the application of this rule, as has developed worldwide, has fit into four categories:

1. When a latent condition of the plaintiff has been unearthed.
2. When the negligence on the part of the wrongdoer re-activates a plaintiff’s pre-existing condition that had subsided due to treatment.
3. Wrongdoer’s actions aggravate known, pre-existing conditions, that have not yet received medical attention
4. When the wrongdoer’s actions accelerate an inevitable disability or loss of life due to a condition possessed by the plaintiff, even when the eventuality would have occurred with time, in the absence of the wrongdoer’s actions.

Thus, the persons to whose cases this rule can be applied are persons who have pre-existing conditions. Considering the benevolent purpose of the Consumer Protection Act, the Court said that the way compensation stood reduced by the State Commission as also the NCDRC, vis-à-vis the District Forum to be based on questionable reasoning.

The Court noted that the State Commission has recognized that the appellant had not been treated “with the care expected at a medical clinic”; she had been suffering from persistent pain right from 2005 until December 2008; and that post-surgical care was deficient which undoubtedly constitutes a deficiency in service. Yet, the Commission found it appropriate to reduce the compensation to a mere Rs.1 lakh. As per the Court, this is not in line with the balance of interests required to be borne in mind while determining compensation.

Further, the Court noted that the NCDRC observed that the appellant’s treatment at the Hospital was ‘casual’; that the excuse of having sought treatment at other hospitals was not available to the respondent Hospital and that she had suffered pain for more than 5 years apart from the case having been dragged on for more than a decade. Yet, NCDRC granted lumpsum compensation was only Rs.2 lakhs.

The Court questioned how such compensation could be justified, after observations having been made regarding the service rendered by the Hospital, being deficient. The Bench said the Compensation by its nature must be just, and described the compensation awarded to the appellant as ‘paltry’.

Further, the Court said that the impugned judgment was silent as to how Eggshell-Skull rule applied to the present case. Nowhere is it mentioned, as to what criteria had been examined. However, the Court said that as per the rule as explained by the NCDRC, there should be a pre-existing vulnerability or medical condition, because of which the victim may have suffered ‘unusual damage’. However, none of the orders – District, State Commission or the NCDRC referred to any such condition.

Thus, the Court set aside the Awards of the NCDRC and State Commission, and further restored the Award as passed by the District Forum. In addition to this, the Bench directed the Hospital to pay a sum of Rs.5 lakhs accompanied by interest at 9% from the date of the award passed by the District Forum to the appellant, within a period of four weeks from the date of this judgment. Also, a cost of Rs.50,000/- was imposed in terms of litigation cost.

Cause Title- Jyoti Devi v. Suket Hospital & Ors. (Neutral Citation: 2024 INSC 330)