Case Note & Summary
The case arises from a consumer complaint alleging medical negligence against Maharaja Agrasen Hospital and its doctors for failing to conduct mandatory Retinopathy of Prematurity (ROP) screening on a preterm baby, Master Rishabh Sharma, born at 32 weeks gestation weighing 1.49 kg on 2 April 2005. The baby was admitted to the hospital's NICU and discharged on 29 April 2005 without any advice for ROP screening. Despite follow-up visits on 4 May 2005 and 13 July 2005, no ROP check was recommended. In November 2005, the mother noticed abnormal visual responses, and subsequent examinations at other hospitals revealed ROP Stage 5 in both eyes, leading to total blindness. The National Commission held the hospital and three doctors (paediatricians and ophthalmologist) guilty of medical negligence, awarding Rs. 11.25 lakhs compensation. Both parties appealed to the Supreme Court. The Supreme Court examined the standard guidelines from the National Neonatology Forum, which mandate ROP screening for all preterm babies born at 32 weeks or less, to be performed at 3-4 weeks of age. The court found that the hospital failed to conduct or advise such screening, and the alleged examination on 26 April 2005 was disputed and not supported by contemporaneous records. The court upheld the finding of negligence, noting that the hospital's failure to provide complete medical records raised an adverse inference. On compensation, the court enhanced the award to Rs. 30 lakhs, considering the child's permanent total blindness, need for lifelong care, loss of earning capacity, and mental agony. The court directed the hospital and doctors to pay the enhanced amount with interest at 9% per annum from the date of the complaint.
Headnote
A) Medical Negligence - Standard of Care - Retinopathy of Prematurity Screening - Failure to conduct mandatory ROP screening on a preterm baby (32 weeks, 1.49 kg) constitutes medical negligence - The hospital and paediatricians failed to advise or perform ROP screening as per National Neonatology Forum guidelines, leading to total blindness - Held that the omission amounts to deficiency in service under the Consumer Protection Act, 1986 (Paras 5-10, 15-20). B) Consumer Protection - Compensation - Permanent Disability - Total blindness of a child due to medical negligence warrants enhanced compensation - The Supreme Court enhanced compensation from Rs. 11.25 lakhs to Rs. 30 lakhs, considering the child's need for lifelong care, loss of earning capacity, and mental agony - Held that compensation must be just and reasonable, covering past and future expenses (Paras 25-30). C) Evidence - Medical Records - Adverse Inference - Non-production of medical records by hospital raises presumption of negligence - The hospital failed to provide complete records despite legal notice, and the alleged ROP examination entry was disputed - Held that adverse inference can be drawn against the hospital for withholding records (Paras 12-14).
Issue of Consideration
Whether the failure to conduct mandatory Retinopathy of Prematurity (ROP) screening on a preterm baby constitutes medical negligence, and what is the appropriate compensation for resulting total blindness.
Final Decision
The Supreme Court dismissed the appeal by the hospital and doctors, upholding the finding of medical negligence. It allowed the appeal by the complainants for enhancement of compensation, awarding Rs. 30 lakhs with interest at 9% per annum from the date of the complaint.
Law Points
- Medical negligence
- deficiency in service
- consumer protection
- standard of care
- burden of proof
- res ipsa loquitur
- compensation for permanent disability
