Kumar Mukherjee v. Ruby General Hospital & Ors

A young boy was hit by a bus while riding his motorcycle to school. He suffered a head injury and was brought to the Ruby General Hospital of Kolkata, which was near the accident, by a passerby. When he arrived at the hospital, he was conscious but was bleeding from the nose and mouth.

At the hospital, according to independent witnesses, he showed hospital workers his Mediclaim policy under which he was insured for 65,000 Indian rupees, promised that fees would be paid, and asked them to start treatment. Hospital workers suctioned blood and provided moist oxygen. However, soon thereafter a clerk asked passerby to deposit 15,000 rupees to continue the boy’s treatment. The passerby collected 2,000 rupees and offered the boy’s motorcycle as collateral for the rest, but the hospital refused, treatment was stopped, and the patient was moved to a government hospital some miles away. He died on the way to the second hospital.

The boy’s parents filed a complaint against the hospital for the hospital’s negligence in stopping treatment.

The Court held that based on the facts as presented, treatment was “started and withdrawn” and there were “no justifiable grounds” for its discontinuation. The Court noted that established principles of medical jurisprudence require providing treatment until “the last breath,” and sometimes even beyond with resuscitation. The Court excerpted The Code of Medical Ethics, which crystallized the duty of doctors, including practicing with skill and not withdrawing treatment from a patient without proper notice to the patient and his family. In its opinion, the Court placed much weight on the “high character” of the medical profession and the medical professional's responsibility to practice with skill and care. The failure to deposit 15,000 rupees was not a justifiable ground for stopping treatment.

In determining the duty of a physician to his patients, the Court excerpted Clauses 10 and 13 of the Code of Medical Ethics:

10. “Though a physician is not bound to treat each and every one asking his services except in emergencies for the sake of humanity and the noble traditions of the profession, he should not only be ever ready to respond to the calls of the sick and the injured, but should be mindful of the high character of his mission and the responsibility he incurs in the discharge of his ministrations, he should never forget that the health and the lives of those entrusted to his care depend on his skill and attention.”

13. “Once having undertaken a case, the physician should not neglect the patient, nor should he withdraw from the case without giving notice to the patient, his relatives or his responsible friends sufficiently long in advance of his withdrawal to allow them to secure another medical attendant. No provisionally or fully registered medical practitioner shall wilfully commit an act of negligence that may deprive his patient or patients from necessary medical care.”

“The patient must not be neglected: A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency or whenever temperate public opinion expects the service. Once having undertaken a case, the physician should not neglect the patient, nor should he withdraw from the case without giving notice to the patient, his relatives or his responsible friends sufficiently long in advance of his withdrawal to allow them to secure another medical attendant. No provisionally or fully registered medical practitioner shall wilfully commit an act of negligence that may deprive his patient or patients from necessary medical care.” Page 9.

“This submission [that the decedent's death was inevitable due to his serious accident] in our view is contrary to established principles of medical jurisprudence. Because, it is known that present day medical science believes in giving treatment till the last breath and for sometime thereafter by resuscitation. The treatment is not given to the patient only in those cases where patient is likely to survive. Treatment is given in all cases. Attempts are made to save the life even in terminal cases. Doctors always hope for the best and survival and they do not predict and say that as the death is inevitable they would stop the treatment.” Page 25.

“It is not merely the alleged harm or mental pain, agony or physical discomfort, loss of salary and emoluments etc. suffered by the appellant which is in issue it is also the quality of conduct committed by the respondents upon which attention is required to be founded in a case of proven negligence. Keeping the aforesaid principles in mind, it would be just and reasonable to award compensation of Rs.10 lakhs for mental pain and agony. This may serve the purpose of bringing about a qualitative change in the attitude of the hospitals of providing service to the human beings as human beings. Human touch is necessary; that is their code of conduct; that is their duty and that is what is required to be implemented. In emergency or critical cases let them discharge their duty/social obligation of rendering service without waiting for fees or for consent.” Page 27.