Deficiency in Service Recognized for Non-Issuance of Medical Records: NCDRC Decision in Deepati v. Shori Hospital

Introduction

The case of Miss Deepati & Others v. Shori Hospital & Others was adjudicated by the National Consumer Disputes Redressal Commission (NCDRC) on July 2, 2020. The petitioners, comprising the wife and children of the deceased, alleged medical negligence and deficiency in service against Shori Hospital and associated parties. The crux of the dispute centered around the treatment provided by Shori Hospital leading to the death of the patient, Mr. Bhushan Kumar Kochar, and the subsequent non-issuance of his medical records.

Summary of the Judgment

The NCDRC reviewed four revision petitions challenging the State Commission's dismissal of the original complaint filed by the petitioners. The District Forum had previously held Shori Hospital and the involved doctors liable for deficiency in service due to non-provision of complete medical records but found no direct medical negligence contributing to the patient's death. The State Commission upheld the dismissal, leading the petitioners to escalate the matter to the NCDRC.

Upon thorough examination, the NCDRC concluded that while Shori Hospital failed to provide complete medical records as mandated by the Medical Council of India (MCI) regulations—constituting a deficiency in service—there was insufficient evidence to attribute the patient's death directly to medical negligence by the hospital or the treating doctors. Consequently, the court upheld the deficiency in service claim, ordering the hospital to compensate the petitioners accordingly.

Analysis

Precedents Cited

The petitioner referenced two key precedents to support their claim:

RP/2605/2012: Dr. N.J. Karnavat v Patel Ishwarlal Mangalal & Ors. – This case highlighted the obligation of medical establishments to provide complete medical records to patients or their authorized representatives upon request.
FA/387/2010: K.Kotaiah Iras vs Dr. T. Anjaiah & Ors. – This judgment further reinforced the liability of hospitals in cases where complete medical records are not furnished, emphasizing the legal requirement under MCI regulations.

These precedents were instrumental in the NCDRC's decision to recognize non-issuance of medical records as a deficiency in service.

Legal Reasoning

The NCDRC meticulously analyzed the sequence of events and the medical records provided. Key points in the court's reasoning included:

Validity of Informed Consent: The court affirmed that the consent obtained by Dr. Sandhu was valid, as it included comprehensive details about the procedure, risks, and benefits, and was signed by the patient's wife due to the patient's critical condition.
Medical Treatment Adequacy: Reviewing operative notes and medical records, the court found that the doctors acted in line with standard medical practices given the patient's severe condition, including septicemia and necrotizing fasciitis.
Deficiency in Service: The failure of Shori Hospital to provide complete medical records was identified as a breach of service, aligning with MCI regulations requiring hospitals to furnish medical documents within 72 hours upon request.
Lack of Direct Negligence: Despite the hospital's deficiency, there was no direct link established between this failure and the patient's death. The court noted that the patient's critical state and the aggressive nature of his illnesses were the primary factors leading to mortality.

Impact

This judgment underscores the legal obligation of medical institutions to maintain transparency by providing complete medical records to patients or their legal representatives. While it recognizes non-compliance as a deficiency in service, it delineates the boundaries of medical negligence, stating that not all failures equate to direct causation of adverse outcomes. This distinction is critical for future litigations, ensuring that hospitals uphold their administrative duties without being unduly burdened by every unfavorable patient outcome.

Complex Concepts Simplified

Deficiency in Service: This refers to a lapse in the standard of care expected from service providers. In this case, Shori Hospital failed to provide complete medical records, which is a breach of duty outlined by regulatory authorities.

Medical Negligence: It involves a breach of duty by medical professionals that directly causes harm to a patient. The court differentiated between administrative lapses and direct medical malpractice, finding no evidence of the latter in this case.

Informed Consent: A process where patients are educated about the risks and benefits of a procedure, allowing them to make knowledgeable decisions regarding their treatment. The court found that the informed consent obtained was valid under the circumstances.

Conclusion

The NCDRC's decision in Deepati v. Shori Hospital highlights the critical importance of administrative compliance in healthcare services. While recognizing the hospital's failure to provide complete medical records as a service deficiency warranting compensation, the court carefully separated this administrative lapse from direct medical negligence. This distinction provides clarity for both healthcare providers and patients, emphasizing the necessity of proper documentation and upholding standards without conflating all service deficiencies with malpractice.