Medical Negligence and Patient Rights: Supreme Court Verdict on Dr. S.K. Jhunjhunwala vs. Dhanwanti Kaur

The case of Dr. S.K. Jhunjhunwala vs. Mrs. Dhanwanti Kaur revolves around a medical negligence claim brought under the Consumer Protection Act, 1986. The case delves into key legal principles regarding a doctor’s duty of care, the standard for medical negligence, and the rights of patients undergoing surgery.

The dispute arose when Mrs. Dhanwanti Kaur, the complainant, accused Dr. Jhunjhunwala of medical negligence following gallbladder surgery that she alleged was performed without her consent. The case passed through multiple judicial levels, from the State Consumer Disputes Redressal Commission to the National Consumer Disputes Redressal Commission (NCDRC), before reaching the Supreme Court.

Background of the Case

Mrs. Dhanwanti Kaur was a resident of Kolkata who sought medical treatment for abdominal pain in June 1996. After consulting a local doctor, she was referred to Dr. Lakshmi Basu, who diagnosed her with gallbladder stones and advised her to undergo laparoscopic surgery. Following this advice, she consulted Dr. S.K. Jhunjhunwala, a renowned surgeon, who confirmed the need for surgical intervention.

The complainant was admitted to Life Line Diagnostic Center and Nursing Home on August 7, 1996. On August 8, Dr. Jhunjhunwala performed the surgery. However, after the initial laparoscopic procedure began, complications were observed, leading to a switch to an open cholecystectomy (conventional surgery) to remove the gallbladder.

Following the surgery, the complainant alleged that she suffered significant health issues, including loss of appetite, jaundice, dysentery, and weight loss. She later underwent a second procedure at Ganga Ram Hospital, New Delhi in 1997 to remove stones that had migrated into her common bile duct. Believing that her initial surgery was conducted negligently, she filed a complaint against Dr. Jhunjhunwala.

Petitioner’s Arguments (Dr. S.K. Jhunjhunwala)

Dr. Jhunjhunwala denied any negligence and argued:

• The complainant had consented to laparoscopic surgery, and clause 4 of the consent form allowed the surgeon to opt for an alternate procedure if required.
• Due to adhesions and inflammation in the gallbladder, laparoscopic surgery was deemed unsafe, necessitating a shift to open surgery.
• The complainant’s husband was informed of this necessity and had provided verbal consent.
• There was no negligence, as every precaution was taken during the surgery.

Respondent’s Arguments (Mrs. Dhanwanti Kaur)

The complainant, Mrs. Kaur, alleged:

• She had consented only to laparoscopic surgery and had never agreed to open surgery.
• The doctor performed open surgery without obtaining her explicit written consent.
• The surgery was not conducted properly, as evidenced by the need for a second surgery within a year.
• She suffered from severe post-operative complications, which she attributed to negligence.

Decisions by the Lower Courts

State Consumer Disputes Redressal Commission (West Bengal)

The State Commission dismissed the complaint, ruling that there was no substantial evidence of medical negligence.

National Consumer Disputes Redressal Commission (NCDRC)

The NCDRC overturned the State Commission’s ruling and awarded Rs. 2 lakh as compensation, holding that:

• The doctor performed a different procedure without explicit consent.
• There was an element of negligence in the post-operative care.
• While the doctor’s skills were not in question, failure to communicate adequately with the patient amounted to medical negligence.

Supreme Court’s Judgment

The Supreme Court, presided over by Justices Abhay Manohar Sapre and Vineet Saran, reversed the NCDRC’s decision and restored the order of the State Commission, dismissing the complaint.

The Court made the following observations:

• “Clause 4 of the consent form dated 07.08.1996 in clear terms empowers the performing doctor to perform such additional operation or procedure, including the administration of a blood transfusion or blood plasma, as they or he may consider necessary.”
• “Having noticed swelling, inflammation, and adhesion on the gallbladder, the appellant came out of the operation theater and disclosed these facts to the complainant’s husband, who agreed to the conventional surgery.”
• “There is no reason to disbelieve that the doctor followed proper medical protocol before proceeding with the surgery.”
• “The complainant failed to provide medical evidence to establish that the doctor’s actions directly led to the complications she later suffered.”

Key Legal Takeaways

1. Medical Negligence Standards

The Supreme Court reaffirmed the principle laid down in the Bolam Test, stating that a doctor is not liable for negligence if they act in accordance with a practice accepted by a responsible body of medical professionals.

2. Consent and Emergency Medical Decisions

The Court emphasized that consent forms permitting alternative procedures, combined with verbal communication with a family member, can justify surgical modifications if deemed necessary during an operation.

3. Burden of Proof in Medical Negligence

The complainant must provide clear medical evidence proving that the alleged negligence directly caused harm. In this case, no such evidence was provided.

Impact of the Judgment

This ruling reinforces protections for medical professionals against frivolous litigation while ensuring patient rights are safeguarded. It establishes a balanced approach to handling medical negligence claims, emphasizing that courts should carefully assess the evidence before holding doctors liable.

The decision serves as a reference for future cases involving informed consent, emergency medical decisions, and professional liability in healthcare.

Petitioner Name: Dr. S.K. Jhunjhunwala.
Respondent Name: Mrs. Dhanwanti Kaur.
Judgment By: Justice Abhay Manohar Sapre, Justice Vineet Saran.
Place Of Incident: Kolkata.
Judgment Date: 01-10-2018.

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