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Background: There is a belief that government–run organizations bear an indifferent, uncaring attitude. This may hold true in the case of government hospitals too, where a doctor’s attitude could underline the difference between life and death.

Case Study: Thangam was admitted to a government hospital, Rajapalayam, on August 6, 1999 for her third delivery. Her husband was informed on August 9 that a Caesarean surgery would be conducted at 10am. But instead of attending to Thangam, the assistant civil surgeon Dr S Alagusundarammal attended to another delivery. Thangam was taken to the operation theatre at 11.25am where she gave birth to a girl. The patient died at 12.05pm.

Karuppiah filed a complaint before the Virudhunagar District Forum, alleging that Thangam had died due to a delay in the delivery and sought a compensation of Rs 2 lakh. The Forum dismissed the complaint, holding that he was not a consumer. Karuppiah appealed to the Tamil Nadu State Commission which held that he would be a consumer entitled to file a complaint. After hearing both parties, it held the doctor guilty of deficiency in service. Karuppiah was awarded a compensation of Rs 50,000 and Rs 2,000 in costs.

The State Commission observed that the medical record at the time of admission had a noting that Thangam was dangerously ill, which also appeared on August 8, 1999. But the operation was performed belatedly on August 9, 1999. No immediate steps were taken and no explanation given for the delay except that the surgery was elective. The doctor’s appeal was dismissed as being devoid of merit. The doctor challenged then approached the National Commission through a revision plea filed belatedly. The explanation given to condone the 260–day delay in filing the revision was that the doctor expected the government to challenge the order. But when the medical officer asked that the compensation be paid by him, the doctor decided to file the plea himself.

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The National Commission observed that departmental delays are not grounds for condonation. It relied on SC observations that government departments are under special obligation to ensure dilifgence in dutyies. Condonation of delay is an exception; it is not be used as anticipated benefit. If a liberal approach is adopted, it would defeat the objective of the Consumer Protection Act prescribing a summary procedure for dispute redressal.

The Commission observed the doctor had delayed the surgery despite recording that Thangam was dangerously ill. The patient’s death within 30 minutes of surgery creates doubts upon conduct and treatment. Even though it was a government hospital, an autopsy was not advised to determine the death cause.

While ruling that there was deficiency in service of the doctor, the Commission observed that in present times the Hippocratic Oath is at stake. The violation of medical ethics by some has led to demoralized health services to the poor. In this case, Karuppiah had lost his wife and the new bornwas deprived of a mother’s love and feed from birth.

Even though the Commission refused to condone delay, it gave its finding on merits and dismissed the revision petition. It also directed the doctor to pay Rs 50,000 along with 9% interest from the complaint date and imposed further punitive costs of Rs 50,000. (Order dated September 9, 2013 in revision petition No 2737 of 2013 in the case of Dr S Alagsundaramma v/s V Karuppiah).

Impact: Government hospital doctors can be held responsible for negligence. Red tape is not a ground for condoning delay. Government agencies cannot claim special treatment. They are on an equal footing with other litigants.

Times of India
23 Sep 2013, Mumbai

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