The Supreme Court of India, in the case of Haseena & Ors. vs. The United India Insurance Co. Ltd. & Anr., has ruled that a death occurring from pulmonary embolism or acute myocardial infarction nearly five months after a motor vehicle accident cannot be considered a direct consequence of the accident without conclusive evidence. A bench of Justices K. Vinod Chandran and N.V. Anjaria upheld a High Court judgment, thereby rejecting the claimants’ appeal for death compensation.
Background of the Case
The case originated from a motor vehicle accident on April 29, 2006, involving an Excise Guard whose motorcycle collided with another. The deceased sustained injuries, including a compound fracture of the second, third, and fourth metatarsals of his right foot and a simple fracture on his left little finger. He was treated as an inpatient until May 3, 2006, and continued treatment as an outpatient.
Due to a non-healing ulcer on his right foot, he was referred to a higher medical centre for plastic surgery. On September 18, 2006, after undergoing a skin grafting procedure, he developed sudden breathlessness and died the same day. The cause of death was certified as “pulmonary embolism/acute myocardial infarction.”
The deceased’s wife, minor child, and mother filed a claim before the Motor Accident Claims Tribunal (the Tribunal). The Tribunal found that the death was a direct consequence of the injuries sustained in the accident and awarded compensation. However, the insurance company appealed to the High Court, which overturned the Tribunal’s finding, leading the claimants to appeal to the Supreme Court.
Arguments and Court’s Analysis
The claimants argued that the non-healing ulcer was a direct result of the accident, which necessitated the surgery that ultimately led to the victim’s death. They relied on the Tribunal’s finding which established a nexus between the accident and the death.
The Supreme Court conducted a detailed analysis of the evidence, particularly the deposition of the plastic surgeon (PW-1) who performed the surgery. The Court noted that while the surgeon stated in his chief examination that pulmonary embolism/acute myocardial infarction could be caused by prolonged bed rest following such injuries, his cross-examination revealed critical contrary details.
The surgeon (PW-1) admitted that the victim had a “history of mild blood pressure and diabetics.” Furthermore, pre-operative tests (Exhibit A-9) showed high cholesterol levels and detected a “Hypertrophy with strain pattern,” which the surgeon testified was a symptom of a cardiac complaint. PW-1 also stated that for a patient with such test results, “chances of a heart attack will be more.”
Crucially, the Court observed that a postmortem was not conducted as the family had objected to it. The surgeon deposed that a postmortem “could have been ascertained” the exact cause of death.
The Supreme Court also dismissed the argument that prolonged bed rest caused the fatal condition, stating, “there is no clear evidence as to such a bed rest having been advised for the patient.” The inpatient treatment was only for a few days, and there was no documentary evidence substantiating a specific period of advised bed rest thereafter.
Final Judgment
The bench concluded that the claimants failed to establish a conclusive link between the accident and the death. The Court found that the victim’s pre-existing medical conditions were significant contributing factors.
In its judgment, the Court stated, “The death could very well have been the after effect of the surgery, given the medical parameters of the patient. It cannot have any direct nexus to the accident which was not conclusively established; the expert medical opinion being otherwise.”
The Court further held that the initial injuries themselves were “not very serious,” and the subsequent non-healing ulcer could have been due to various causes, especially the victim’s diabetic condition.
Ultimately, the Supreme Court found no reason to interfere with the High Court’s “well-considered judgment.” The bench concluded, “Merely by reason of the proximity of the accident and the death or the possibility of acute myocardial infarction occurring for reason of a long bed rest, it cannot be assumed, without clear evidence to substantiate the death having been caused as a result of the injuries sustained in the accident that the death occurred by reason of the accident. There cannot be found even a preponderance of probability, going by the Doctor’s evidence.”
The appeal was dismissed, and the High Court’s decision to reject the claim for death compensation while allowing the claim for injuries was affirmed.
