Medical Negligence explained in fewer than 500 words

Medical Negligence: An Overview

Medical negligence, often referred to as medical malpractice, occurs when a healthcare professional fails to provide the standard level of care, leading to harm or injury to the patient. It is a serious issue within healthcare systems worldwide and encompasses various aspects of medical errors. This article explores what constitutes medical negligence, its causes, consequences, and preventive measures.

Definition of Medical Negligence

Medical negligence is legally defined as a breach of duty of care by a healthcare professional that results in harm to the patient. This breach occurs when a healthcare provider's actions deviate from the accepted standards of practice, either through a direct action or failure to act. Unlike unavoidable medical complications, negligence implies an error that could have been prevented if the proper level of care had been exercised.

2. Common Causes of Medical Negligence

Medical negligence can arise from a range of causes, including but not limited to:

Misdiagnosis or Delayed Diagnosis: A wrong or delayed diagnosis can lead to incorrect or delayed treatment, often worsening the patient’s condition.

Medication Errors: Mistakes in prescribing, dispensing, or administering medication can result in adverse reactions or failure to treat the patient’s condition effectively.

Surgical Errors: Errors during surgery, such as operating on the wrong site, leaving foreign objects inside the body, or causing nerve damage, are severe forms of negligence.

Anesthesia Errors: Incorrect dosages or failure to monitor a patient under anesthesia can lead to serious complications or even death.

Lack of Informed Consent: When a healthcare provider fails to inform a patient about the risks associated with a procedure, the patient cannot make an informed decision, potentially leading to harm.

3. Legal Elements of Medical Negligence

To establish a medical negligence claim, four main elements must be proven:

1. Duty of Care: It must be established that the healthcare professional owed a duty of care to the patient.
2. Breach of Duty: Evidence must show that the healthcare professional breached this duty by not meeting the required standard of care.
3. Causation: The breach of duty must be directly linked to the harm or injury suffered by the patient.
4. Damages: The patient must have suffered harm, injury, or losses that can be compensated.

These elements form the foundation for legal claims and are essential in holding medical practitioners accountable.

• The Bolam-Narayan Saha (BNS) Test

The Bolam-Narayan Saha Test, often referred to as the “Bolam Test” in combination with the Indian adaptation set forth by the Supreme Court in the Dr. Laxman Balkrishna Joshi v. Dr. Trimbak Bapu Godbole case and the Jacob Mathew v. State of Punjab case, helps to define medical negligence in India. This test is used to determine whether a healthcare provider acted within acceptable professional standards and is based on the following principles:

The Bolam Principle

Origin: The Bolam Test originated from the English case Bolam v. Friern Hospital Management Committee (1957).

Definition: According to this principle, a doctor is not considered negligent if they act in a manner that is accepted as proper by a reasonable body of medical professionals skilled in that particular area.

Application: This test protects healthcare providers from liability as long as their actions are consistent with accepted medical practice, even if others might have handled the case differently.

Indian Adaptation – Narayan Saha Principles

The BNS Test further interprets the Bolam principles in light of Indian legal standards, accounting for local conditions and the high threshold for criminal liability. The Indian judiciary refined these principles through cases, emphasizing two aspects:

Distinction Between Civil and Criminal Negligence: Civil negligence implies a lack of reasonable care, while criminal negligence under IPC requires “gross negligence” or recklessness that significantly endangers life.

Reasonable Skill and Care: A medical professional is expected to possess reasonable skill and judgment relevant to their field. A mere error in judgment or a difference in treatment opinion does not constitute negligence unless there is evidence of reckless disregard for the patient’s safety.

Bolam Test Combined with Narayan Saha Guidelines

In the Jacob Mathew case, the Supreme Court emphasized that a medical professional should not be held criminally liable unless their actions exhibit a high degree of negligence or recklessness. This ruling has provided a balance, helping to protect patients’ rights while also safeguarding doctors from frivolous lawsuits.

Medical negligence under BNS is likely to keep provisions similar to IPC Section 304A, Section 337, and Section 338,are s.106, addressing cases of medical harm or death caused by negligent or reckless actions.

Death due to Negligence: The BNS may continue to classify medical actions causing death due to negligence as criminal offenses, punishable by imprisonment and/or fines. The concept of “gross negligence” would still be essential to establish criminal liability, as not all errors qualify for punishment.

Injury due to Negligence: Sections similar to IPC 337 and 338 will likely be included in BNS, focusing on cases where medical negligence causes “hurt” or “grievous hurt.” These would address less severe but still harmful cases of negligence.