Res Ipsa Loquitur and Its Application in Medical Negligence

Introduction

“Res Ipsa Loquitur” means things speak for itself essentially instructing the courts of law that in circumstances specifically to the field of medicine proof of negligence is not require beyond the act itself. The application of this principle has also been in India on various accounts. It should be note that Res Ipsa Loquitur comes into effect only after there has been a proof that the event occurred was originally unexpected and rarest of the rare alongside it should also be shown that the accident or the event which happened did not have any lapse or negligence on the part of the doctor.  

Application in India

In India whenever the principle of Res Ipsa Loquitur has been applied to the judge but common conscience has accept that

• The first and foremost important point and an equally important checkpoint is that the doctor must have been in an exclusive control directionally of the circumstance in which the act was commission and commit to a point that injury was beyond the control
• In common prudence the injury must have been without any violation of legal duty.
•  And lastly, the person injured or the patient should not have been the aggregator of the injury

 Into the time it has been well settled that this maxim is now no more just than an interference of negligence based on circumstantial evidence provided. This has essentially happened because of the advancements made in the field of medicine loss of trust and the rise of cost plays another crucial role in the rising medical negligence cases. The whole plethora of cases under medical negligence have been included in the consumer protection act. In the year of 1993 and since there has been a surge in cases relating to medical negligence. 

Overlook of Cases

The applicability of Res Ipsa Loquitur cannot be complete without proper legal backing. That is essentially looking at the previous presidents or landmark judgments in the area of medical negligence

In one such case before the Madras High court, it has observed that the basis of fixing the liability cannot be on the sole view adopted by doctors, however, in a case where the act has been done by a doctor which he is not supposed to do on his own onus the burden of negligence shall be upon the man himself[1]. One essential fact that came out of this case was that the court said that the person performing the surgery is in a position of facts which are very crucial and the life of a person depends upon which presumption the doctor cannot escape the liability. Furthermore, the Apex court says that there are situations where this principle is apply:[2]

1. Cases involving gross negligence including but not being limit to the usage of wrong drugs.[3]
2. Mismatch in blood transfusion resulting in death.[4]
3. Development of gangrene.                       
4. Patient suffering paralysis (in case facial paralysis referred).
5. Delay in gaining medical advice during the pregnancy of a woman, effectively affecting the baby.
6. Brian damage suffered because of inadequate treatment.
7.  Suffrage of coma of a healthy girl.

The courts in this country have also come out to explicitly state that a simple and sensible usage of the maxim Res Ipsa Loquitur (a general mode of referring an issue in the factual matrix) is always subject to the application of all other principles. In this process the satisfaction of which is sought before the court can proceed with conviction. The procedure is that

1. Objective circumstances that makeup facts of accidents and from where the guilt is assume must be establish firmly.
2. Circumstances should be presenting a determining tenancy towards the charges of a person.
3. A chain of events must complete and link all the parts together to point that the person is to be held liable.
4. It should be beyond any reasonable doubt.

Conclusion

What effect will this new trend have upon the practice of medicine? Is the most important question that needs to be answered while some feel that this doctrine is important for enforcing the duty of doctors, But no one can fail to see the impact of this attitude upon the medical profession to use only those procedures that pose the least threat of legal liability, regardless of their relative curative value[5]. Thus the Indian courts have to be careful to establish such professional negligence.

References:

[1] M/S.Soni Hospital vs Arun Balakrishnan Iyer and Ors. [AIR 2003 Mad 389]

[2] V.KISHAN RAO vs. NIKHIL SUPER SPECIALITY HOSPITAL [CIVIL APPEAL NO. 2641 OF 2010]

[3] Spring Meadows Hospital v. Harjol Ahluwalia [CIVIL APPEAL NO. 7858 OF 1997]

[4] Postgraduate Institute of Medical Education and Research v. Jaspal Sing [CIVIL APPEAL NO. 7950 OF 2002]

[5] Rudolf F. Binder, Res Ipsa Loquitur in Medical Malpractice, 17 Clev. [Marshall L. Rev. 218 (1968)]