1968 (5) TMI 66 - SC - Indian Laws

Summary

Issues Involved:

1. Liability of the surgeon for alleged neglect towards his patient.
2. Adequacy of the preliminary examination and treatment given.
3. Determination of the cause of death.
4. Evaluation of the evidence and findings of the lower courts.
5. Assessment of damages.

Issue-wise Detailed Analysis:

1. Liability of the Surgeon for Alleged Neglect Towards His Patient:

The appeal raises the question of the liability of a surgeon for alleged neglect towards his patient. The respondents claimed that the appellant did not perform the essential preliminary examination before starting treatment and administered morphia without proper assessment. They alleged that the appellant used excessive force for manual traction without proper anesthesia, leading to conditions favorable for embolism or shock, which proved fatal.

The appellant denied these allegations, asserting that he performed a preliminary examination and decided against general anesthesia due to the patient's exhausted condition. He claimed that he only immobilized the fractured femur with slight traction using plaster splints.

2. Adequacy of the Preliminary Examination and Treatment Given:

The trial court found that the appellant had carried out a preliminary examination before starting the boy's treatment. However, the High Court concluded that the appellant's claim of a thorough preliminary examination was untrue. The clinical chart did not record the temperature, raising doubts about the thoroughness of the examination.

The High Court also rejected the appellant's claim of delaying the reduction of the fracture due to swelling, elapsed time since the accident, and the boy's exhaustion from the journey. The court found no evidence of swelling or other symptoms justifying delayed reduction. The appellant's case paper did not accurately reflect the treatment given, further undermining his credibility.

3. Determination of the Cause of Death:

The trial court concluded that the appellant performed the reduction of the fracture with excessive force without anesthesia, resulting in cerebral embolism or shock, causing the boy's death. The High Court concurred, finding that the appellant's treatment led to shock, not cerebral embolism as claimed.

The appellant's letter to respondent 1, expressing remorse and seeking forgiveness, indicated uncertainty about the cause of death, further supporting the conclusion that the treatment caused shock. The appellant's failure to warn respondent 1 about the possibility of fat embolism and the absence of symptoms associated with embolism suggested that the boy's death was due to shock from the treatment.

4. Evaluation of the Evidence and Findings of the Lower Courts:

Both the trial court and the High Court found respondent 1's version of events more credible than the appellant's. Respondent 1, a medical practitioner, was present throughout the treatment and observed the appellant's actions. The courts accepted his testimony that the appellant assured him the boy would recover from the morphia effect by 7 p.m., contradicting the appellant's claim of mere immobilization.

The courts also noted that the appellant's failure to follow medical guidelines for delayed reduction and his reliance on a single morphia injection contradicted his defense. The appellant's apologetic letter and the absence of embolism symptoms further supported the conclusion that the treatment caused shock.

5. Assessment of Damages:

The trial court awarded general damages of Rs. 3,000 to the respondents, finding the appellant guilty of negligence and wrongful acts resulting in the boy's death. The High Court upheld this award, and the Supreme Court found no grounds to interfere with the concurrent findings of the lower courts.

Conclusion:

The Supreme Court dismissed the appeal, affirming the findings of the trial court and the High Court that the appellant was guilty of negligence and wrongful acts towards the patient, leading to the boy's death. The appellant's failure to perform a thorough preliminary examination, use of excessive force without proper anesthesia, and subsequent actions were deemed negligent, justifying the award of damages.