The Supreme Court has affirmed that the doctrine of 'Res Ipsa Locutor' may be invoked in cases where there is strong incriminating circumstances or documentary evidence of negligence are available.

Case Brief -

A bench of Justices A S Bopanna and Prashant Kumar Mishra  rejected, an appeal filed by her pertained to the death of her 37-year-old husband, Sankar Rajan, who passed away on November 6, 1998, due to a heart attack, reportedly as a result of alleged medical negligence during a significant neurosurgical procedure at Indraprastha Apollo Hospital.

Ranjan asserted that the deceased had undergone surgery on October 29, 1998, and had subsequently been moved to a private room. He experienced neck pain and contacted the doctors. Tragically, he suffered a heart attack at approximately 11 pm. His condition deteriorated to the point of being declared brain dead on October 31, and he remained on life support until his eventual demise on November 6, 1998.

She raised a valid grievance that there was a significant lapse in medical care. Specifically, she pointed out that no doctor from the neurosurgery team, who had conducted the surgery on the deceased, attended to him after he was moved to the private room, and this continued until 11:00 P.M. Furthermore, given the magnitude of the surgery, it was argued that the deceased should have been placed in the Intensive Care Unit (ICU) rather than a private room. It's worth noting that the deceased had no prior history of cardiac issues, yet he tragically suffered a cardiac arrest.

The bench, however, said, "There is no evidence put forth by the complainant to establish that heart attack suffered by the patient had any connection with the operation in question or that it was on account of negligent post operative care."

"Therefore, it was difficult for treating doctors including the duty doctor or the hospital to assume that the patient may suffer cardiac arrest and moreover, the patient had also not complained of pain in any other part of the body except neck region," the bench said.

The court also emphasized that the current case is distinguishable, as it does not involve a diagnostic error or a negligent diagnosis made by the doctor.

"In the absence of the patient having any history of diabetes, hypertension, or cardiac problem, it is difficult to foresee a possible cardiac problem only because the patient had suffered pain in the neck region," the bench reiterated.

The hospital and the doctors had submitted an affidavit from Prof. Gulshan Kumar Ahuja, a professor of neurosurgery at AIIMS and a senior consultant in neurology. After a thorough examination of the medical records and CT scan, Prof. Ahuja concluded that there was no evidence of any abnormalities at the surgical site. He also stated that the complications experienced by the patient were entirely unrelated to the surgery. Prof. Ahuja further asserted that symptoms such as neck pain, sweating, and nausea were not indicative of a cardiac or respiratory arrest.

Apollo Hospital also provided statistics, indicating that during the months of September to November 1998, out of a total of 166 neurosurgeries performed, only 68 patients were transferred to the Intensive Care Unit (ICU) from the recovery room, while the remaining patients were discharged to their respective wards.

Case Title: Mrs Kalyani Ranjan Vs Indraprastha Apollo Hospital & Ors

Click here to Read/Download the Orders