JYOTI DEVI V. SUKET HOSPITAL 

2024 SCC OnLine SC 581

(Decided on April 23, 2024, before Justice Sanjay Karol and Justice Aravind Kumar)

Advocates who appeared in this case: 

1. For Petitioner(s) –

Mr. Subhash Chandran Kr, Adv. 

            Ms. Krishna Lr, Adv.

            Mr. Biju P Raman, AOR 

2. For Respondent(s) Mr. Mritunjay Kumar Sinha,

 AOR Ms. Binisa Mohanty, Adv.

 Mr. Rameshwar Prasad Goyal, AOR

(Judgment was given by Justice Sanjay Karol)

FACTS:

• The appellant, Jyoti Devi underwent appendectomy surgery at Suket Hospital, Sundernagar, Mandi, Himachal Pradesh on 28^th June 2005, performed by Dr. Anil Chauhan, Senior Surgeon at the Suket Hospital. She was discharged on 30^th June and after the discharge, she experienced persistent pain at the surgical site. She was readmitted to Suket Hospital in July but discharged with assurances of no further pain and discomfort. For further treatment, she was referred to Dr. L.D. Vaidya of Mandav Hospital by Dr. Anil Chauhan, but the pain did not subside and her suffering continued for four years. The Post Graduate Institute of Medical Science in Chandigarh discovered a 2.5 cm needle (foreign body) near the site of the surgery in her abdomen, necessitating further immediate surgery for its removal.
• Jyoti Devi filed a case in the District Consumer Disputes Redressal Commission for compensation for medical expenses and mental as well as physical agony she suffered due to the negligent act of the Suket Hospital amounting to Rs.19,80,000. The District Consumer Disputes Redressal Commission granted her Rs.5,00,000 for negligence on the part of the hospital. On the appeal of the Suket Hospital, the State Consumer Disputes Redressal Commission reduced the compensation amount to Rs.1,00,000. Dissatisfied with the decision, Jyoti Devi filed a second appeal at the National Consumer Redressal Commission that enhanced the compensatory amount to Rs.2,00,000.
• Jyoti Devi then filed a special leave petition at the Supreme Court of India because she was not satisfied with the compensation granted by the National Consumer Disputes Redressal Commission.
• The case involved a claim of medical negligence, which is a crucial element of the Consumer Protection Act of 1986.
• The court, in addition to this discussed that while determining compensation in cases of medical negligence, a balance has to be maintained between the demands of the person claiming the compensation and the interests of those liable to pay it.
• Moreover, the court highlighted the eggshell skull rule, in which the injurer is held liable for damages that exceed the amount of injury that would have been caused in normal circumstances. 

ISSUES RAISED:

• How will the court determine the compensation to be awarded to the appellant?
• Did the respondents, Suket Hospital and Dr. Anil Chauhan, commit medical negligence by breaching the duty of care towards the appellant pre and post-surgery of appendicitis as per the Consumer Protection Act of 1986? 
• Were the respondents liable for their wrongful act or negligence as per the eggshell skull rule in the law of torts?

CONTENTIONS OF THE APPELLANT:

• The appellant accuses the respondents of gross medical negligence. They claim that a needle was left in the appellant’s abdomen, causing prolonged pain and discomfort.
• The post-operative care given by the respondents was below the reasonable standard, according to the appellant. This substandard care resulted in the appellant experiencing prolonged pain in her abdomen for five years, which necessitated further medical treatments.
• As a result of the respondents’ medical negligence and deficiency in medical care, she is claiming compensation for the bodily distress and mental agony she endured post-surgery for five years. The appellant is not satisfied with the grant awarded by the Consumer Disputes Redressal Commissions and is demanding a higher amount. She requests higher compensation and to justly address her prolonged sufferings.
• The appellant demanded the application of the eggshell skull rule due to her pre-existing sensitivity that aggravated her medical conditions and increased the negative effects of the hospital’s negligence. 

CONTENTIONS OF THE RESPONDENTS:

• The respondents contended that they diligently followed the medical guidelines and protocols during the surgery. They provided the standard care to the appellant pre and post-surgery without any negligence on their part.
• They argued that the medical care provided by other hospitals or medical practitioners as sought by the appellant in five years might have worsened the condition and her pain. 
• The respondents further argued that there was a gap period of one and a half years where the appellant did not suffer any pain in her abdomen therefore the accusation of medical negligence is unjustified.

RATIONALE:

• The court first examined the scope of the Consumer Protection Act, of 1986. This legislation is designed to safeguard the interests of the consumers of a good or a service or both. Its primary objective is to provide the complainants with quick and cost-effective remedies in cases of any fault in the good or insufficiency of the service. The judicial bodies are established at district, state, and national levels to litigate consumer disputes and award fair compensation to all the complainants. 
• Second, the court highlighted that three factors required to prove medical negligence, as observed by the “Supreme Court in M.A Biviji v. Sunita, following the landmark pronouncement in Jacob Matthew v. State of Punjab, are:—

 (1.) a duty of care extended to the complainant,

 (2.) breach of that duty of care, and

 (3.) resulting in damage, injury, or harm caused to the complainant attributable to the said breach of duty;

However, a medical practitioner will be held liable for negligence only in circumstances when their conduct falls below the standards of a reasonably competent practitioner.”

• Third, the court navigates the complex task of balancing the exaggerated claims based on unjustified pieces of evidence. The compassion for the victim should not hinder the accurate determination of the compensatory amount. When the court is satisfied by the evidence having sufficient justification, it would grant adequate compensation to the victim. The idea of compensation is based on the Latin maxim restitutio in integrum which means that the compensation granted should be sufficient to restore the complainant to his original position as when if he would not have suffered any loss or injury. 
• Lastly, the court emphasized the eggshell skull rule where the person having an eggshell skull is the one who would be severely affected by an act that would not impact any normal person otherwise. 

Here, the injurer is liable for all the injuries arising out of his wrongful act, whether the consequences could have been easily foreseen or not. “There are four categories for which the eggshell skull is applicable. They are:

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. 

As these categories and, the name of the rule itself suggest, the persons to whose cases this rule can be applied, are persons who have pre-existing conditions.”

The Supreme Court was satisfied that the respondents were negligent and held them liable for medical negligence. It was not satisfied by the decisions of the lower courts in granting compensation though they also acknowledged the fact that the respondents were negligent in offering adequate healthcare facilities to the appellant. The court restored the compensatory grant awarded by the District Consumer Disputes Redressal Commission in the form of the sum of Rs.5,00,000. This sum was accompanied by the interest of 9% p.a. from the date of the award passed by the District Consumer Disputes Redressal Commission in the sum of Rs.5,00,000. Along with this sum, the court ordered the respondents to pay Rs.50,000 as the litigation cost expended by the appellant. 

DEFECTS IN LAW:

There is no defect in the decision of the court. The Supreme Court has upheld its judgment in favor of the appellant, Jyoti Devi who suffered the medical ordeal for a period of five years due to the medical negligence of the respondents, Suket Hospital and Dr. Anil Chauhan. A person is said to be medically negligent when he omits to take reasonable standard care by a competent medical practitioner.  The court has analyzed the facts and circumstances of the case and arrived at the appropriate decision by striking a balance between the demands of the person claiming the compensation and the person who is held to be liable to pay the compensation.

INFERENCE:

The Supreme Court established a precedent by upholding the rights of patients according to the Consumer Protection Act and upheld the hospital and the surgeon liable for the medical negligence pre and post-surgery of the appellant. The court set aside the decisions of the National and State Consumer Disputes Redressal Commissions for their decision to award inadequate compensation to the appellant for the damage she suffered due to the wrong acts of the respondents for a prolonged duration. The court ordered the award of Rs.5,00,000 to the appellant as earlier decided by the District Consumer Disputes Redressal Commission along with the interest of 9% p.a. from the date of the decision of the District forum in addition to litigation costs of Rs.50,000.

Submitted By:

Name: Yagyanika Negi

College: Vivekananda Institute of Professional Studies, GGSIPU