Neeraj Sud vs Jaswinder Singh (Minor) (2024) - Case Analysis

Introduction of Neeraj Sud vs Jaswinder Singh (Minor) (2024)

Neeraj Sud vs Jaswinder Singh (Minor) 2024 case centres around a complaint filed by a father on behalf of his minor son against Dr. Neeraj Sud and the Post Graduate Institute (PGI) of Medical Education & Research, Chandigarh for Medical Negligence. The Supreme Court on 25th October, 2024 held that Dr. Sud followed an accepted medical practice. The Court applied the Bolam Test and ruled that he was not responsible for the complications that arose post-surgery.

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Why in the Spotlight? - Neeraj Sud vs Jaswinder Singh (Minor) (2024)

The Bench comprising Justice Pankaj Mittal and Justice PS Narasimha held that a doctor following an accepted medical practice cannot be held liable for complications post-surgery. The Court highlighted that medical negligence requires proof of a duty of care, a breach of that duty and resultant damage.

Historical Context and Facts of Neeraj Sud vs Jaswinder Singh (Minor) (2024)

The case at hand involved two appeals that arose from a decision by the National Consumer Disputes Redressal Commission (NCDRC) regarding a medical negligence complaint filed against Dr. Neeraj Sud and the Post Graduate Institute (PGI) of Medical Education & Research, Chandigarh. The following are the brief facts of the case -

Background and Facts of the Case

The Complainants, father and his minor son, filed a complaint alleging medical negligence against PGI and Dr. Neeraj Sud who was an ophthalmologist. In this case, the 6-year old son was diagnosed with a congenital eye disorder called PTOSIS (drooping eyelid). On 26th June, 1996 he underwent surgery which was performed by Dr. Neeraj Sud.

Allegation of Negligence

The Complainants claimed that the surgery was performed negligently which resulted in deterioration of the condition rather than improvement. The child had normal vision (6/9 in both eyes) and a moderate case of PTOSIS before the surgery. The PTOSIS after the surgery worsened from moderate to severe and the vision of the child deteriorated from 6/9 to 6/18 with additional complaints of double vision.

Initial Findings of the State Commission

On 27th May, 2005 the State Commission initially dismissed the complaint. The Commission found that there was no negligence. It ruled that Dr. Sud had provided proper treatment and that the recurrence of PTOSIS was a known complication that could be addressed with a repeat surgery.

Decision of the NCDRC

Aggrieved by the decision of the State Commission, the Complainants filed an appeal in the NCDRC. However, the NCDRC overturned the findings of the State Commission partly based on a re-examination of medical records. The NCDRC observed that the patient had good vision and a moderate PTOSIS before surgery. However, post-surgery, the condition worsened and the vision of the patient deteriorated. The NCDRC ruled that Dr. Sud was negligent in not providing proper treatment and not performing a repeat surgery when required. Thus, the NCDRC held both Dr. Sud and PGI jointly and severally liable for compensation of Rs. 3,00,000 and additional costs.

Position of the Defendant

The Defendants Dr. Sud and PGI admitted performing the surgery and claimed that PTOSIS correction and recurrence were common complications.They also contended that after January 1997 the patient was not re-examined by Dr. Sud as treatment was sought elsewhere.

Compensation and Appeal

The Complainants sought compensation of Rs. 15,00,000 for suffering and Rs. 4,55,000 for treatment costs. The NCDRC awarded compensation of Rs. 3,00,000 and Rs. 50,000 in costs. Aggrieved by the decision of the NCDRC the defendants filed an appeal in the Supreme Court.

Issue addressed in Neeraj Sud vs Jaswinder Singh (Minor) (2024)

The main questions which were addressed in this case were -

• Whether the deterioration of the condition of the patient post-surgery constituted actionable negligence?
• Whether the practitioners comply with the accepted standards of medical care?

Legal Provisions involved in Neeraj Sud vs Jaswinder Singh (Minor) (2024)

In the recent Supreme Court Judgement of Neeraj Sud case the concept of Bolam Test played a significant role. The following is the analysis of the Bolam Test -

The Bolam Test

Bolam Test is a legal principle originated from an English case. It states that a medical professional cannot be considered negligent if their actions are in accordance with a practice recognized by a group of medical practitioners, even if there are differing opinions from others.

Judgment and Impact of Neeraj Sud vs Jaswinder Singh (Minor) (2024)

The Supreme Court in Neeraj Sud case held that a doctor who complies with an accepted practice within the medical profession will not be held responsible for complications arising post-surgery. The Court affirmed that a doctor cannot be held liable for medical negligence only because a patient did not respond positively to the treatment or surgery or if the surgery failed. 

The Supreme Court applied the doctrine of Res Ipsa Loquitur which suggests negligence in the absence of direct evidence does not automatically apply unless evidence shows that the doctor failed to exercise the necessary skill in the discharge of their duties.

The Court also highlighted that negligence in medical practice requires the following three elements: 

• a duty to exercise due care
• a breach of that duty
• resultant damage

However, mere errors in judgment, accidents or lack of a better treatment alternative are not sufficient to prove medical negligence.

The Supreme Court referred to a landmark English Case of Bolam vs Friern Hospital Management Committee (1957) where the concept of Bolam Test was introduced. The Test states that a medical professional will not be considered negligent if their actions comply with a practice deemed acceptable by a group of medical experts.

The Supreme Court also referred to Jacob Mathews vs State of Punjab (2005) where the Bolam Test was adopted and highlighted that the standard of care should be determined by what is accepted by a body of medical practitioners.

Thus, the Supreme Court ruled that no substantial evidence was produced by the Complainant which showed that Doctor Neeraj Sud or PGI misapplied their expertise and no testimony from the expert medical board to prove that the Dr. Neeraj Sud had not exercised his skills properly.

Conclusion

In Neeraj Sud vs Jaswinder Singh (Minor) (2024) the Supreme Court upheld that a doctor following an accepted medical practice cannot be held liable for complications post-surgery. The Court highlighted that medical negligence requires proof of a duty of care, a breach of that duty and resultant damage.