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Doctors can be put in the dock for denying emergency care to patients, says Pushpa Girimaji LAST year, the apex consumer court had taken a hospital to task for its avariciousness. The verdict was in response to a complaint where a hospital had denied emergency treatment to an accident victim on the ground that it had not received the required deposit from the patient or those who brought him to the hospital. (Pravat Kumar Mukherjee vs Ruby General hospital, OP no 909 of 2002) Now in a recent order, the National Consumer Disputes Redressal Commission has criticised an ESI hospital for turning away an emergency case without providing any medical care and held that it constituted negligence on the part of the doctors and the hospital. In fact, the court has in this case held the ESI hospital negligent on several counts: for the absence of a duty doctor when the patient arrived; for the undue delay — of five long hours — in eventually looking at the patient; and turning away the patient without providing any treatment on the ground that there were no "beds". Together, these two orders should ensure that doctors and hospitals do not forget their duty towards patients and turn away emergency cases either on the ground that the required money has not been paid or on the ground that the hospital is full. In fact, in the case of Pravat Kumar, the court had called for an attitudinal change in the way hospitals and doctors in the private sector looked at patients. "In emergency or critical cases, the doctors and hospitals must discharge their duty and render medical service without waiting for the fee," the Commission had said. In the case of Ranjit Kumar Das, it has expressed concern over the plight of patients who are denied treatment on some pretext or the other and reminded the doctors about the "duty of care" expected of them. The Commission has also decried the mechanical approach to patient care and called for humane treatment of patients. It has also reminded doctors and hospitals about the code of medical ethics that binds them to provide proper medical care. This particular case revolves around the way Mrs Ranjit Kumar Das, an ESI card holder was mistreated, when she went with acute abdominal pain to an ESI hospital in Kolkata. Even though she went to the hospital at 6.30 am, no doctor saw her till 11.30 am that day. And then, he just noted that she was suffering from acute abdominal pain and at 12.30 pm asked her to seek medical assistance from any other ESI hospital as there was no "bed" available. The other ESI hospital too turned her away without giving her any treatment. Eventually, she was admitted to a private nursing home, where she breathed her last the next day. The West Bengal State Commission awarded her family Rs 2 lakh as compensation and Rs 5000 towards costs. This was objected to by the ESI, which filed an appeal before the National Commission. Dismissing the appeal, the highest consumer court in the country said, first of all, there was no doctor on duty when the patient arrived at the ESI hospital. A duty doctor came only at 8 am. And then she was attended to only much later and even then, despite being diagnosed with "acute abdominal pain", no medicine was administered to the patient. The diagnosis was merely recorded and the patient was asked to approach some other ESI hospital. The Commission pointed out: the hospital was obliged to entertain and treat the cardholder. Instead, the doctor on duty showed complete apathy and refused to treat her, thereby endangering her life. Saying that this constituted deficiency in the service rendered and negligence too, the apex consumer court said it did not see any reason to differ with the opinion of the State Commission. Observed the Commission: A doctor is required to attend to an emergency patient with alacrity and not adopt a mechanical approach of referring or forwarding the case or pushing out the patient to some other hospital. In this case, there has been a complete failure on the part of the doctors as well as the hospital to provide the duty of care expected from them However, it calculated the quantum of compensation on the basis of the monthly salary that Mrs Das was getting and the hike in salary that she would have got and said Rs 1,25,000 would be a reasonable compensation. But it awarded an interest of 9 per cent per anum, calculated from August 1, 1994, till the date of payment. (Medical Oficer, ESI hospital, Manicktala, Kolkata and another vs Shri Ranjit Kumar Das and ors, First appeal no 313 of 1997).
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