Medical Service (CPAM) Torts

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INTRO-

Doctor owes certain duties to the patient who consults him for illness. A
deficiency in this duty results in - negligence, vitiated consent,
and breach of confidentiality

The patient-centered initiative of rights protection is required to be appreciated in the
economic context of the rapid decline of State spending and massive private investment
in the sphere of the health care system The patient-centered initiative of rights
protection is required to be appreciated in the economic context of the rapid decline of
State spending and massive private investment in the sphere of the health care system
The patient-centered initiative of rights protection is required to be appreciated in the
economic context of the rapid decline of State spending and massive private investment
in the sphere of the health care systemThe patient-centered initiative of rights
protection is required to be appreciated in the economic context of the rapid decline of
State spending and massive private investment in the sphere of the health care system

Torts- Civil wrong
---unfairly causes someone else to suffer loss or harm resulting in legal liability
---The victim of the harm can recover their loss as damages in a lawsuit. In order to prevail, -----------
---The plaintiff in the lawsuit must show that the actions or lack of action was
the legally recognizable cause of the harm.

Who can file a complaint?
A consumer or any recognized consumer association, i.e.,
voluntary consumer association registered under the Companies Act, 1956 or any other
law

Who is a consumer?
A consumer is a person who hires or avails of any services for a consideration and
includes any beneficiary of such services other than the person hires or avails of the
services for consideration
What is a complaint?
A complaint is an allegation in writing made by a Complainant,
What is deficiency of service?
Deficiency of service means any fault, imperfection, shortcoming, or inadequacy in the
quality, nature, or manner of performance that is required to be maintained by or under
any law for the time being in force or has been undertaken to be performed by a person
in pursuance of a contract or otherwise in relation to any service.
Where is a complaint filed?
District-<20 lakh
State-<1crore
National- >1 crore
Supreme court ( appeal, within 30 days)

What are the powers of the consumer redressal forums?
The forums have a variety of powers. They are 1) the summoning and enforcing of the
attendance of any defendant or witness and examining the witness under oath, 2) the
discovery and production of any document or other material object producible as
evidence, 3) the reception of evidence on affidavits, 4) the summoning of any expert
evidence or testimony, 5) the requisitioning of the report of the concerned analysis or
test from the appropriate laboratory or from any other relevant source, 6) issuing of any
commission for the examination of any witness, and 7) any other matter which may be
prescribed.
MEDICAL NEGLIGENCE - DEFINITIONAL ASPECTS
Negligence is simply the failure to exercise due care. The three ingredients of negligence
are as follows:
1. The defendant owes a duty of care to the plaintiff.
2. The defendant has breached this duty of care.
3. The plaintiff has suffered an injury due to this breach.

When does a duty arise?
It is well known that a doctor owes a duty of care to his patient. This duty can either be a
contractual duty or a duty arising out of tort law.

What is the duty owed?
The duty owed by a doctor towards his patient, in the words of the Supreme Court is to
bring to his task a reasonable degree of skill and
knowledge and to exercise a reasonable degree
of care (Laxman vs. Trimback).
- Doesnt mean save every patient.

Reasonable degree of care
Reasonable degree of care and skill means that the degree of care and competence that
an ordinary competent member of the profession who professes
to have those skills would exercise in the circumstance in question.
---The degree of care is a variable and depends on the
circumstance. It is used to refer to what actually amounts to reasonableness in a
given situation.
---Generalist and a specialist,
---Hence, we can conclude that a doctor has to constantly update his
knowledge to meet the standard expected of him.


When does the liability arise?
In order to show the breach of duty, the burden on the plaintiff would be to first
show what is considered as reasonable under those circumstances and then
that the conduct of the doctor was below this degree.

Normally, the liability arises only when the plaintiff is able to discharge the burden on
him of proving negligence. However, in some cases like a swab left over the abdomen of
a patient or the leg amputated instead of being put in a cast to treat the fracture, the
principle of res ipsa loquitur (meaning thereby the thing speaks for itself)
might come into play. The following are the necessary conditions of this principle.
1. Complete control rests with the doctor.
2. It is the general experience of mankind that the accident in question does not happen
without negligence. This principle is often misunderstood as a rule of evidence, which it is not. It
is a principle in the law of torts. When this principle is applied, the burden is on the
doctor/defendant to explain how the incident could have occurred without negligence. In the
absence of any such explanation, liability of the doctor arises.

CONCLUSION
The Hon'ble Mr. Justice Markendeya Katju has done yeoman service for society by
rendering this judgment. On one hand, it sets at rest the speculative nature of our
judicial adjudication of medical negligence liability and on the other, it abundantly
clarifies that unless there is prima facie evidence indicating medical negligence, notice
either to a doctor or hospital cannot be issued. At the same time, the core essence of the
judgment makes it very clear that there cannot be an assumption that doctors cannot be
negligent while rendering care and treatment. I think this timely intervention should be
disseminated at a popular level so that the mandated Supreme Court's prescription will
be observed more in practice than in breach.

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