The National Consumer Disputes Redressal Commission has cleared a private hospital and its doctor of medical negligence in the death of a 54-year-old cancer patient, ruling that a delayed malignancy diagnosis does not automatically establish medical malpractice.
The apex consumer tribunal set aside a February 16, 2018 directive of the Delhi State Consumer Commission that had held the healthcare providers liable. While absolving the hospital and physician of negligence, the national panel ordered that Rs 5 lakh already deposited by the hospital be released to the deceased patient’s family with interest as an ex-gratia relief toward medical expenses.
Legal Standards for Medical Negligence
In an order issued on September 21, a bench comprising Presiding Member AVM J Rajendra and Justice Anoop Kumar Mendiratta stated that negligence cannot simply be deduced from a subsequent cancer diagnosis. The commission affirmed that claimants must provide evidence showing that the provided medical care deviated from accepted professional practice or that the attending physician failed to exercise the standard of care expected under the circumstances.
Under the state commission’s earlier ruling, the hospital had been directed to deposit Rs 20 lakh, out of which Rs 5 lakh was allocated to the complainants, while the doctor was instructed to pay Rs 2 lakh. With the finding of negligence overturned, the NCDRC directed that the Rs 2 lakh penalty levied on the doctor be refunded after 30 days if already deposited.
Treatment Timeline and Delayed Diagnosis
The case originated from the medical care of a patient, identified as Jaswani, who sought treatment for back pain in September 2005. Following an MRI scan at another private facility on September 9, a doctor diagnosed him with diabetes, a left psoas abscess, and spinal tuberculosis in the L2-L3 region.
Jaswani was admitted to the hospital on September 11 and underwent surgical debridement the next day, during which tissue was sent for laboratory analysis. He was discharged on September 16 following an uneventful recovery.
According to the complainants, the patient’s condition deteriorated in the months that followed. On December 27, during the absence of the primary treating physician, another hospital doctor, Dr Kapoor, examined the patient and requisitioned the pending histopathology report from an outsourced diagnostic centre.
The test results identified an undifferentiated malignant tumour, noting possibilities of malignant fibrous histiocytoma, liposarcoma, or lymphoma. Jaswani was referred to an oncologist and subsequently examined at AIIMS, Delhi on January 3, 2006. He died on June 23, 2006.
Institutional Tracking and Patient Responsibility
The patient’s family contended that the hospital and physician failed to review the biopsy findings in a timely manner, resulting in fatal delays in cancer therapy. In response, the hospital and doctor maintained that the report, processed by an external diagnostic facility, was never submitted to them during intermediate consultations.
The NCDRC concluded that there was no proof showing when the diagnostic report was collected or that it had been presented to the treating physician before December 27. The bench ruled that the doctor could not be held liable when the biopsy results were not produced during follow-ups and no evidence proved prior knowledge of their availability.
The tribunal also evaluated the initial clinical care, finding the tuberculosis diagnosis and treatment aligned with accepted medical standards because the preliminary imaging pointed to tuberculosis and tissue was appropriately biopsied to verify the condition. The commission further cited observations from the Delhi Medical Council noting the tumour’s high malignancy and that an earlier intervention had not been proven to alter the patient’s ultimate outcome.
While the commission pointed out coordination shortcomings in ensuring outsourced diagnostic reports reached patients swiftly, it held that such administrative lapses do not equate to medical negligence. The panel concluded that healthcare institutions should maintain structured mechanisms to trace and relay crucial diagnostic tests, while noting that patients must also ensure pending test results are collected and presented during subsequent consultations.
