Pune: Medical Negligence Case

Experience cannot count as a replacement for a specialized qualification. The Maharashtra State Consumer Forum has made this amply clear in a medical negligence case pointing out that an MBBS doctor not having a PG in Anesthesia, despite having experience in the field, cannot be considered as an Anesthetist.

The case is that of a five-year-old child, who was admitted to the Grant Medical Foundation Ruby Hall Clinic, Pune for the purpose of removal of kidney stones under the care of Dr. Balwant Singh Ratta, a qualified Euro Surgeon. She was operated upon by Dr. Ratta, with Dr. Rusi Nariman Marolia, the anesthetist attached to the hospital, administering pre-operative anesthesia to the patient. On the day of operation, in the evening the patient became critical as the heartbeats were reduced though put on ventilator. Unfortunately, soon after the child (patient) died. The family, alleging medical negligence by doctors, filed a case with the Consumer Court.

Core Issues of the Complaint

• Whether opponent no.2 i.e. Dr. Balwant Singh Ratta exercised due caution while carrying out the operation for removal of the kidney stones of the patient?
• Whether informed and valid consent was obtained prior to carrying out operation for removal of kidney stones?
• Whether Opponent No.3. Dr. Rusi Nariman Marolia is qualified and authorized to claim himself as an Anesthetist to administer anesthesia to the patient?

An expert committee of doctors from Sassoon hospital was appointed to investigate the incident. It is reported that while both the expert Committee and the hon'ble court found no negligence on the first two points, it was the qualification of Dr. Marolia that came under question.

The Committee arrived at the conclusion that Dr. Rusy Marolia, though he may not have a degree in anesthesia, has the basic qualifications. Since 1st August 1966 to 31st January 1969, he worked as a Resident Doctor in Sassoon General Hospital and obtained knowledge and expertise in surgical anesthesia. From the year 1975, he has been practicing as an anesthetist in the opponent no.1 hospital, and the Committee expressed its opinion that the training and experience gained by Dr. Rusy Marolia i.e. opponent no.2 is sufficient qualification to work as an anesthetist.

The court, however, did not agree with the committee, pointing out that hiring a doctor with an MBBS qualification to the post of anesthetist was in violation of the Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002, which prohibit an unqualified person from practicing in a field in which he does not have the requisite qualification. It was also in contravention of the law as interpreted by the Supreme Court in the case of Poonam Verma v/s Dr. Ashwini Patel where unqualified persons were held to be quacks and charlatans.

We are of the opinion that the Medical Council of India and Maharashtra Medical Council dealing with modern medicines and the practitioners registered with them shall take cognizance of the fact that the unqualified person viz. Dr. Rusy Marolia has been there in the opponent no.1 hospital for years practicing as an anesthetist on the basis of some certificate and elementary training at his command jeopardizing lives of patients.

Owing to the above fact, the court held both the hospital and the doctor liable for negligence. Dr. Marolia, without there being requisite qualification as required under the statute rules and regulations, has been working as an Anesthetist since 1975 with the Opponent no.1 hospital, which per se establishes guilty of negligence against him and also warrants action by competent authorities, i.e. Indian Medical Council and Maharashtra Medical Council. It is unassuming that the opponent no.1, a public trust running the hospital to render services to the patient, has employed opponent no.3 – Dr. Marolia as Anesthetist, even though he does not possess the required qualification as per the norms and standards laid down for the post of Anesthetist. In view of this, both Dr. Marolia and the opponent no.1 are liable for negligence per se in rendering services to the patient. We, on this background, are convinced to hold deficiency in service against opponent nos.1 and 3 for serious medical negligence.

With this, the court ordered the hospital as well as Dr. Marolia to pay a lump sum compensation of Rs 10 lakhs to the parents of the deceased child, and an additional amount of Rs 80,000 for expenses and litigation costs. It was directed that compliance of the order should be made within 45 days, else the amounts awarded would carry interest at 9% for the period of delay. A copy of the judgment has been forwarded to the Medical Council of India for disciplinary action.

You can read the full judgment below.