Poor nursing care, no excuse

Pushpa Girimaji

Can I hold a hospital accountable for not providing proper nursing services? My wife, a cancer patient, was admitted to a private hospital for treatment. However, because of poor nursing care, she developed certain complications and eventually breathed her last. In response to my complaint, the hospital blamed inadequate nursing staff for the problem, but the hospital had refused my request for allowing a private nurse. Can I file a complaint under the Consumer Protection Act against the hospital?

From your question, it is not very clear whether the hospital failed to provide the required nursing care to your wife or whether the complications were a result of the negligent services provided by the nursing staff. Whatever the case may be, the hospital is certainly liable.

If the hospital, for example, did not have the requisite number of nursing staff to attend to patients, then the hospital is guilty of not providing adequate infrastructure or staff, resulting in deficient services. It is also guilty of negligence if it hired unqualified nurses. Even if it is a case of negligence by paramedical staff, the hospital is accountable because the hospital as the employer is vicariously liable for the negligence of its staff.

In Harjot Ahluwalia Vs Spring Meadows Hospital (OP No 292 of 1994, order dated June 16, 1997), the National Consumer Disputes Redressal Commission made it clear that a hospital is vicariously liable for the negligence of its employees — both medical and paramedical. In this case, where the administration of a high dose of chloriquine instead of chlorphenicol by the nurse had caused irreversible damage to the brain cells of young Harjot, the hospital was held liable.

So, please go ahead and file a complaint. But do remember that you have to establish, through medical records and expert opinion, if necessary, that poor paramedical services led to your wife suffering complications, leading eventually to her death.

Can you quote a case law that would help me with my claim for compensation?

The order of the National Consumer Disputes Redressal Commission in Commandant, Base Hospital (Army), Delhi Cantt and others Vs Wg Cdr. KK Chaudhary (retd) (RP No 3247 of 2008, date of order February 2, 2009), establishes the importance of paramedical services in patient care.

In fact, in this case, there was no evidence linking the death of the complainant’s wife to the absence of paramedical assistance. However, there was evidence that she did not receive critical nursing care, which she badly needed. On this count, the consumer courts held the hospital deficient in its services and awarded compensation to the complainant.

Here, the complaint was that the complainant’s wife was suffering from cirrhosis of the liver, was completely bed-ridden and was in no position to take care of herself. Yet, she was not provided that critical nursing care required during her hospital stay from December 5 to December 8, 2003, when she breathed her last.

The complainant said that in view of the paucity of nursing staff at Base Hospital, he had taken special permission from the duty medical officer to allow his daughter to stay with her mother and take care of her. However, on the night of her death, the gastroenterologist treating her had refused permission to his daughter to stay with her and there was no one with his wife when she died.

The Commission here observed that the patient was terminally ill and there was no chance of her recovery. There was also no evidence to prove that her death was a consequence of medical negligence. However, it was the duty of the hospital to ensure 24-hour nursing help to such critically ill patients and this was not provided. If there was paucity of nurses, the hospital should have allowed the daughter to stay with her at night, but even this was denied. So the Commission upheld the view of the lower consumer courts that the complainant had to be compensated for the mental anguish, trauma and harassment undergone as a result.

However, while the lower consumer courts awarded a compensation of Rs 50,000 in this case, the National Commission reduced it to Rs 25,000.

Your case is slightly different in that you can establish a link between poor quality nursing or lack of nursing care and the complications that your wife developed, leading eventually to her death.