‘Error of judgment is not medical negligence’

Hospital accused of failing to diagnose a patient with cancer

In a significant ruling, the National Consumer Disputes Redressal Commission has made a distinction between medical negligence and “error of judgment” while rejecting a complaint against a private hospital of Delhi, which was accused of failing to make a correct diagnosis of cancer in a patient. The patient later died during treatment in another hospital.

Complainant Kamani Sharma had charged a doctor in Pamposh Medical Care Centre at Pamposh Enclave here with diagnosing her husband with tuberculosis Rajinder Sharma in December 1999, while he was actually suffering from cancer. The patient later approached LNJP Hospital, Rajiv Gandhi Cancer Hospital and Sir Ganga Ram Hospital, where he was diagnosed as an advanced case of lung cancer and metastasis.

The patient underwent biopsy at Maulana Azad Medical College and took treatment at Sir Ganga Ram Hospital. In spite of best efforts, he died on November 19, 2000.

Ms. Sharma alleged that it was the wrong diagnosis of tuberculosis initially made at Pamposh Medical Care Centre that led to the critical condition of her husband and his death within a short span of 11 months. She sought a compensation of Rs.65 lakh for medical negligence and deficiency in service.

A Bench of the Commission, comprising Justice J.M. Malik and S.M. Kantikar, dismissed the complaint last week, while holding that it was a case of “error of judgment” rather than medical negligence. The Bench said Rajinder did not turn up at the hospital for eight months and its doctor never treated him.

The Commission noted that the patient was a heavy smoker and drug addict and had earlier received anti-tubercular therapy (ATT) for testicular TB. There was a possibility of healed TB focus or sarcoidosis. “We are of the considered view that it was an error of judgment that the doctor failed to diagnose cancer at the initial examination of the patient.”

Applying the principle of “loss of chance” to the instant case, the Bench held that the failure to diagnose would not matter so much as the patient was suffering from frank metastasis in brain and liver. There were less than 50 per cent chances of survival, it said and absolved the doctor of the charge of negligence.

The Commission rejected the complaint and said the advice given at Pamposh Medical Care Centre for investigations and biopsy of the lesion for proper diagnosis was not followed. “After the lapse of eight months, the patient went to LNJP Hospital, which became fatal for him...It was negligence of the patient, for which the doctor is not liable.”