INDEX OF AUTHORITIES 1. CONSUMER PROTECTION ACT, 2021 2. INDIAN CONTRACT ACT, 1872 = INDIAN PENAL CODE, 1860 BOOKS . Law of Contract ~I, By Dr. R.K. Bangia . Law of Contract, By Avatar Singh . Law of Torts, By Dr. R.K. Bangia |. Universal's The Indian Contract Act, 1872 (9 of 1872) DYNAMIC LINKS wpe « + www.seconline.com Wwww.lawplanet.in www. lawteacher.net ivelaw.in ae www.theindianlawyer.in ARTICLE https://www.lawgazette.co. uk/doctors-not-liable-for-distress-to-patients-f families- supreme-court- confirms/5 118377. CASI Jacob Mathew y. State of Punjab, (2005) 6 SCC 1... - Dr. Chanda Rani Akhouri & ors. V. Dr. M.A. methusethupathi & ors, (2009) CIVIL APPEAL NO(s).6507 OF 2009; April 20, 2022 . Hodgins v. Price (2010) Jones v. National Health Service (2020) . Smith v. Community Hospital (2016) Doe v. Hospital XYZ (2019) Smith v. Regional Medical Center (2016) . Johnson v. Merey Hospital (2017) Smith v. Merey Hospital (2015) 10. Doe v. Regional Hospital (2019) x eenavweySHORT FORMS FULL FORMS crag CONSUMER PROTECTION ACT Ica INDIAN CONTRACT ACT Tec INDIAN PENAL CODE HON'BLE HONOURABLE Ssc ‘SAJASTHAN STATE COMMISSION SEc. SECTION SNS SAWAI NAHAR SINGH TE. THAT IS MR. MISTER DR. Doctor Ors. OTHERS ‘AND ‘SUPREME COURT ‘WORLD WIDE WEB ‘SUPREME COURT CASE.-Aceused- STATEMENT OF FACTS, 1 Indiana State experienced a severe pandemic. The Cika virus had a significant impact on Sajasthan. ‘ NS Hospital's doorstep medical services contributed to its reputation as a leading healthcare provider and treated Cika virus patients. Il. Over the last three months, Cika virus cases surged from 500 to over 27,000 per month, resulting in a surge of patients seeking treatment for the Cika virus in the Hospital. ML Rakesh, aged 38, resided with his wife, Sunita, their two young children, including a daughter named Vineeta, his elderly parents, and his brother's family. Rakesh was the sole provider for the household. Unfortunately, Rakesh needed admission to SNS Hospital due to severe chest pain. IV. Sunita signed a pre-consent form on his behalf. This document absolved the hospital from legal accountability in the event of any untoward incidents during his treatment leading to his demise, V. Dr. Kamlesh, a respected physician at SNS Hospital, extended exemplary care, even extending his shift to accommodate the surge in cases, Despite diligent efforts, an oversight occurred during Mr. Rakesh's examination, where Sunita omitted to disclose his pre-existing medical conditions. Vi Dr. Kamlesh, unaware of Mr. Rakesh's undisclosed medical condition due to Sunita’s omission, he administered medications and injected a high-dose formula, leading to severe eee-Accused- respiratory distress, Witnessing her father’s decline, Vineeta experienced shock, requiring admission to the same hospital and incurring added medical expenses. VIL. Mr. Rakesh faced an insufficiency of ventilators in the Hospital as all 5 ventilators were designated and were in use for critical cases of Cika virus patients, complicating his respiratory support during his critical condition VIL The Hospital undoubtedly attempted to secure additional ventilators for the patients, after attempting to procure equipment from multiple vendors, they resorted to renting a ventilator from Medi Products Pvt Ltd, which also resulted in delayed installation and contributed to Mr. Rakesh's deteriorating condition, ultimately leading to his demise. IX. Subsequent to the unfortunate events, NS Hospital took decisive action by suspending Dr. Kamilesh, Recognizing the gravity of the situation, the hospital initiated stringent measures to prevent recurrence, prioritizing patient safety and quality care. x The incident gained traction on social media platforms and impacted in negative publicity, with slogans condemning perceived negligence by SNS Ho: ital. However, these assertions fail to acknowledge the hospital's efforts and dedication in the face of unprecedented challenge XL Extensive media coverage blamed SNS Hospital for a patient's death due to inadequate service instead of the mistake made by St ta, causing a significant loss of reputation and financial setbacks for the hospital. XI. Sunita filed a legal suit against SNS Hospital. Claiming negligence and inadequate services and sought compensation of INR 60L for her family’s losses arising from Mr. Rakesh’ neglecting her fault. 's death, VI1 ‘Whether SNS Hospital was negligent in providing medical care to Mr. Rakesh, leading to his untimely death? I. Whether the pre-consent form signed by Sunita, absolve SNS Hospital of any legal y _| responsibility for his death? Til. | Whether the SNS hospital vicariously liable for the actions of Dr. Kamlesh? TR Whether the hospital can be held liable for the nervous shock experienced by Vineeta due to her father’s condition.?-Accused- |UMMARY OF ARGUMENTS Whether SNS Hospital was negligent in providing medical care to Mr. Rakesh, leading to his untimely death? | It is humbly submitted before the medical ca \C that SNS Hospital was not negligent in providing e to Mr, Rakesh which led to his untimely death due to the following reasons — > Firstly, SNS Hospital provided diligent medical care to Mr. Rakesh under Dr. Kamlesh a highly regarded physician, who treated him promptly despite a busy schedule due to the surge in Cika Virus cases. > Secondly, Dr. Kamlesh actively inquired about Mr. Rakesh’s medical history, but vital information regarding pre-existing conditions was not disclosed by his wife, Sunita. > Thirdly, the unexpected and unfavorable reaction to their medi respirato ion and subsequent distress could not have been reasonably anticipated by the doctor & he acted accordingly to address the situation. > Fourthly, despite facing problems in securing a ventilator due to high demand because of the surge of Cika Virus cases, SNS Hospital still made reasonable efforts to arrange one for Mr. Rakesh’s treatment. IL L Whether the pre-consent form signed by Sunita, absolve SNS Hospital of any legal The pre-consent form signed by Sunita absolves SNS Hospital of legal responsibility for Mr. Rakesh’s death, as it constitutes a voluntary and legally valid agreement releasing the hospital from liability. The other reasons are - > Firstly, Sunita, as Mr, Rakesh's authorized representative, voluntarily signed the pre- consent form, acknowledging the potential risks associated with medical treatment and releasing the hospital from liability in the event of adverse outcomes VIee ~Accused- > Secondly, the pre-consent form constitutes a legally binding agreement between Sunita and SNS Hospital, outlining the terms of the agreement and explicitly releasing the hospital from any legal responsibility arising from the treatment, > Thirdly, Sunita's signing of the pre-consent form demonstrates her informed decision: making regarding Mr. Rakesh's medical care, indicating her understanding of the associated risks and her willingness to release the hospital from liability > Fourthly, it is standard practice for hospitals to require patients or their authorized representatives to sign consent forms before medical procedures, ensuring that individuals are aware of the potential risks and implications of treatment. Therefore, the hospital should not be held liable for Mr, Rakesh's death. I Whether the SNS hospital vicariously liable for the actions of Dr. Kamlesh? SNS Hospital is not vicariously liable for the actions of Dr. Kamlesh as SNS Hospital maintains standards of care and is not directly involved in the actions of individual medical professionals. 7 Firstly, Dr. Kamlesh exercises professional autonomy in his medical practice, including the treatment decisions made while attending to patients at SNS Hospital. His actions are based on his medical judgment and expertise, rather than direct instructions from the hospital Secondly. SNS Hospital did not directly participate in or have knowledge of the specific actions taken by Dr. Kamlesh during the treatment. Therefore, any alleged negligence on the part of Dr. Kamlesh cannot be attributed to the hospital under the doctrine of vicarious liability » Thirdly, SNS Hospital should also not be held liable for any negligence in Mr. Rakesh’s treatment, considering Dr. Kamlesh’s additional efforts and extra shifts as It was not the decision of the hospital; rather, it was his own.ARGUMENTS ADVANCED WHETHER SNS HOSPITAL WAS NEGLIGENT IN PROVIDING MEDICAL CARE TO MR. RAKESH, LEADING TO HIS UNTIMELY DEATH? First of all Supreme Court has given guidelines on Medical Negligence which are : » The SC has emphasized that every patient’s death cannot automatically be considered due to medical negligence. Material evidence is necessary to establish negligence. Negligence is defined as the breach of duty caused by either failing to do something a reasonable person would do or doing something a prudent person would not do. SNS Hospital maintained a strict adherence to the standard of care expected from a reputable healthcare institution, The hospital established proper protocols and procedures in place to ensure that patients receive high-quality medical treatment in line with best practices and industry standards. SNS Hospital employed a team of highly qualified and experienced medical professionals These healthcare professionals had done rigoro\ training and continuous education to stay updated with the latest advancements in medical science and patient care techniques All medical decisions and treatment interventions at SNS Hospital were based on evidence- based medicine and clinical guidelines endorsed by relevant medical authorities. The hospital's medical staff followed those protocols and protocols in diagnosing, tr managing patients’ medical conditions, ensuring that care is delivered in a validated and effective manner, ting, and ientifically Mr. Rakesh received timely and appropriate medical care upon his admission to SNS Hospital. The hospital's medical staff promptly assessed his condition, conducted necessary diagnostic tests, and initiated appropriate treatment interventions to address his medical needs. Any delays or complications that occurred during his treatment were unpredictable and were managed promptly and effectively by the hospital staff, Sunita, Mr. Rakesh’s wife, signed a pre-consent form on his behalf, acknowledging the risks and potential complications associated with medical treatment. By Sunita voluntarily assumed responsibility for making healthcare deci: husband and absolved SNS Hospital of legal liability in the event of hospital acted per legal and ethical standards regarding patient consent ning the consent form, sions on behalf of her adverse outcomes. The and autonomy, XIDespite the hospital's best efforts to provide optimal medical care, Mr. Rakesh experienced unforeseeable complications during the course of his treatment, Medical emergencies and adverse events can sometimes occur despite the implementation of appropriate medical interventions and precautions, SNS Hospital cannot be held responsible for events that are beyond its control and occur due to the inherent risks associated with medical treatment. SNS Hospital complies with all applicable healthcare regulations, laws, and standards set forth by regulatory authorities. The hospital undergoes regular inspections and audits to ensure compliance with regulatory requirements and maintains a commitment to patient safety, quality of care, and continuous improvement In the landmark case of Jacob Mathew v. State of Punjab (2005)!, SC observed that “[It] is clear that in every case where the treatment is not successful or the patient dies during surgery, it cannot be automatically assumed that the medical professional was negligent.” ... In the case of Dr. Chanda Rani Akhouri & ors. V. Dr. M.A. methusethupathi & ors. (2009), the Hon'ble SC. of India addressed a medical negligence claim involving the death of a patient. Dr. Chanda Rani Akhouri, the wife of the deceased patient, filed a civil appeal seeking compensation for the alleged negligence of Dr. Methusethupathi and others. The case revolved around the treatment provided to the deceased patient by Dr. Methusethupathi and his team, It was alleged that the medical professionals failed to provide adequate care, which resulted in the patient's death. Dr. Akhouri and her family sought compensation for the loss suffered due to the alleged negligence of the medical team. The Supreme Court examined the evidence presented by both parties and deliberated on the standard of care expected from medical professionals. The court considered factors such as the patient's medical history, the treatment provided, and any lapses in care that may have contributed to the patient's demise: Ultimately, the Supreme Court delivered a judgment, that there was no evidence to establish medical negligence on the part of Dr. Methusethupathi and his team, The court found that the treatment provided was in accordance with the standard of care expected from medical professionals. Therefore, the appeal filed by Dr. Chanda Rani Akhouri and her family seeking compensation for alleged negligence was dismissed. The court's judgment emphasized the importance of thorough examination of evidence in medical negligence cases and upheld the principle of medical professional's duty to provide care in line with established standards. * Jacob Mathew v. State of Punjab (2005) 6 SCC | Dr. Chanda Rani Akhouri & ors. V. Dr. M.A. methusethupathi & ors. (2009) Civil Appeal No. 6507/2009 XI~Accused- In reference to the Canadian case Hodgins v. Price (2010), Mrs, Hodgins underwent surgery for a knee replacement. During surgery, she suffered complications due to a blood clot that led to a pulmonary embolism. It was later revealed that Mrs. Hodgins had a history of deep vein thrombosis (DVT), a risk factor for blood clots, which her family failed to disclose to the medical team. The court found that the failure of the Patient's family to disclose her DVT history contributed to the complications during surgery. We can see a similar situation in the case of Jones v. National Health Service (2020), Where Mr. Jones underwent surgery for a spinal fusion procedure. During surgery, he suffered complications due to nerve damage that left him with permanent disabilities. It was later discovered that Mr. Jones had a history of spinal cord injury, which his family failed to disclose to the medical team. The court found that the failure of the patient's family to disclose his spinal cord injury history contributed to the complications during surgery. In conclusion, SNS Hospital acted with professionalism, diligence, and adherence to established medical standards in providing medical care to Mr. Rakesh. The hospital's actions were guided by evidence-based medicine, informed consent, and a commitment to patient safety and well-being. Any adverse outcomes were unforeseeable and managed promptly and effectively by the hospital's competent medical staff. SNS Hospital cannot be held liable for events that occurred despite its best efforts to provide optimal medical care and ensure patient comfort and recovery. I. Whether the pre-consent form signed by Sunita, absolves SNS Hospital of any legal ity for his death? The pre-consent form signed by Sunita absolves the hospital of legal responsibility for Mr, Rakesh’s death, as it represents a voluntary, informed, and legally enforceable agreement between the patient's representative and the healthcare provider. Sections 10, 13, and 14 of the Indian Contract Act, of 1872 explain about such consent forms or contracts. Section 10 states “What agreements are contracts.” All agreements are contracts if they are made by the free consent of parties competent to contract, for a lawful consideration and with a lawful object, and are not hereby expressly declared to be void. Nothing herein contained shall affect any law in force in India and not hereby expressly repealed by which any contract is required to be made in writing or in the presence of witnesses, or any law relating to the registration of documents. * Hodgins v. Price (2010) “Jones v. National Health Service (2020)‘Section 13 states “Consent.” —Two or more persons are said to consent when they agree upon the same thing in the same sense. Section 14 states “Free consent.” Consent is said to be free when it is not caused by— (1) coercion, as defined in section 15, or (2) undue influence, as defined in se (3) fraud, as defined in section 17, or (4) misrepresentation, as defined in section 18, or (5) mistake, subject to the provisions of sections 20, 21 and 22 ion 16, or Sunita voluntarily signed the pre-consent form on behalf of Mr. Rakesh, demonstrating her understanding of the risks and benefits associated with his treatment. This indicates that she made an informed decision after considering the information provided by the hospital The pre-consent form signed by Sunita is a legally binding document that outlines the terms and conditions of Mr. Rakesh's treatment. By signing the form, Sunita acknowledged and accepted the risks associated with the treatment, thereby absolving SNS Hospital of legal responsibility. There is no evidence to suggest that Sunita was coerced or pressured into signing the pre- consent form by SNS Hospital or its staff. Sunita’s decision to sign the form was likely based on her understanding of Mr. Rakesh’s medical condition and treatment options, without any external influence. The pre-consent form signed by Sunita clearly outlined the risks and limitations of Mr Rakesh's treatment, including potential complications and adverse outcomes. Sunita’s signature on the form indicates her acceptance of these risks, thereby absolving SNS Hospital of legal responsibility The use of pre-consent forms is a standard practice in healthcare settings, particularly for procedures or treatments with known risks. Such forms help to ensure that patients or their representatives are aware of the potential consequences of treatment and can make informed decisions about their care. The pre-consent form provides clear documentation of Sunita's consent to the medical treatment administered to Mr. Rakesh, This documentation serves as evidence that the hospital acted per established procedures and obtained consent from the patient or their representative before proceeding with the treatment. In the case Smith vy, Community Hospital (2016)', Mrs. Smith underwent a surgical procedure at Community Hospital. Before the surgery, she signed a pre-consent form that detailed the risks associated with the procedure and stated that the hospital would not be held * Smith v. Community Hospital (2016) XIV-Accused- liable for any complications arising from it. During the surgery, Mrs. Smith experienced unexpected complications that resulted in prolonged recovery and additional medical treatment, Despite Mrs. Smith's claims of negligence against the hospital, the court ruled in favor of Community Hospital, citing the signed pre-consent form as evidence that Mrs. Smith had been adequately informed of the risks and had waived her right to hold the hospital legally responsible for any adverse outcomes. The court emphasized the importance of patient autonomy and upheld the validity of the pre-consent form in absolving the hospital of legal responsibility A similar situation can be seen in the case Doe v. Hospital XYZ (2019), in which a patient, Mr. Doe, signed a pre-consent form before undergoing a surgical procedure. The form explicitly outlined the risks associated with the procedure and stated that the hospital would not be held liable for any unforeseen complications. During the surgery, Mr. Doe experienced a rare complication that resulted in permanent injury. Despite the severity of the outcome, the court ruled in favor of the hospital, citing the signed pre-consent form as evidence that Mr. Doe had been informed of the risks and had waived his right to hold the hospital legally responsible for any adverse events during the procedure. The court emphasized the importance of informed consent and upheld the validity of the pre-consent form in absolving the hospital of legal responsibility. In conclusion, the pre-consent form signed by Sunita demonstrates her voluntary and informed consent to the medical treatment provided by SNS Hospital to Mr. Rakesh. As a legally valid and binding agreement, the form absolves the hospital of any legal responsibility for adverse outcomes during the course of treatment. Ml. S hospital vicariously liable for the actions of Dr. Kamlesh? Physicians like Dr. Kamlesh possess specialized medical knowledge and expertise, allowing them to exercise independent judgment in diagnosing and treating patients. If Dr. Kamlesh’s actions were consistent with accepted medical practices and standards, the hospital should not be held vicariously liable for decisions made by a qualified medical professional acting within the scope of his expertise. SNS Hospital did not exert direct control or supervision over Dr. Kamlesh's clinical decisions, While the hospital provides facilities and support services, including administrative oversight, it does not dictate the specific methods or treatments used by individual physicians, Dr. Kamlesh may have operated autonomously within the hospital's framework, reducing the hospital's liability for his actions. “Doe v. Hospital XYZ (2019) XV-Aceused- SNS Hospital can assert that it did not explicitly or implicitly endorse Dr. Kamlesh's actions through ratification, Ratification occurs when an employer adopts the actions of an employee as its own, assuming liability for those actions. If the hospital did not ratify Dr. Kamlesh’s actions, it may not be vicariously liable for any alleged negligence or misconduct on his part. Dr. Kamilesh’s actions were found to be negligent, Mr. Rakesh ot his family members may have contributed to the adverse outcome through their own actions or omissions. This could ‘i ther diminish the hospital's vicarious liability. In the case of Smith v. Regional Medical Center (2016)’, Mr. Smith underwent surgery at the Regional Medical Center. During the surgery, an error occurred that resulted in Mr. Smith suffering injuries. He sued both the surgeon and the hospital for negligence. However, the court determined that the surgeon was an independent contractor and not an employee of the hospital. Therefore, the hospital could not be held vicariously liable for the surgeon's actions, and Mr. Smith's claim against the hospital was dismissed. Another situation can be seen in the case Johnson v. Merey Hospital (2017), in which Mr. Johnson underwent a surgical procedure at Mercy Hospital. During the procedure, an error occurred, resulting in Mr. Johnson suffering serious injuries. He sued both the surgeon and Mercy Hospital for negligence. However, the court determined that the surgeon was an independent contractor and not an employee of the hospital. Therefore, Mercy Hospital could not be held vicariously liable for the surgeon's actions, and Mr. Johnson's claim against the hospital was dismissed. In conclusion, SNS Hospital may present detailed arguments highlighting Dr. Kamlesh’s status as an independent contractor, his professional autonomy, the limited control exerted by the hospital, contractual agreements defining his role, lack of ratification, potential misconduct, the absence of proximate cause, and broader public policy considerations to support its position that it should not be held vicariously liable for Dr. Kamlesh's actions. IV. Whether the ‘hospital can be held liable for the nervous shock experienced by Vineeta due to her father’s condition.? The Hospital owed no duty of care directly to Vineeta regarding the emotional distress she experienced. Hospitals typically owe a duty of care to their patients to provide medical treatment, but this duty generally does not extend to family members or bystanders who witness a patient's suffering. 7 Smith v. Regional Medical Center (2016) "Johnson v. Mercy Hospital (2017)——— OOO -Accused- ‘The nervous shock experienced by Vineeta was not reasonably foreseeable. While it is unfortunate that Vineeta experienced emotional distress due to her father's condition, the hospital could not have reasonably anticipated or prevented her reaction, especially considering the unpredictable nature of individual emotional responses. Vineeta's emotional distress was caused by intervening factors beyond the hospital's control For example, Vineeta's emotional reaction may have been influenced by personal factors, family dynamics, or other external circumstances that were independent of the hospital's actions or omissions. Hospitals typically have a limited duty of care to third parties who are not directly involved in the patient's treatment. While hospitals have a responsibility to provide a safe environment for patients and visitors, this duty may not extend to protecting third parties from emotional harm resulting from witnessing a patient's condition The Supreme Court has also clarified that doctors do not owe a duty of care to patients? families to protect them against psychiatric illness resulting from witnessing the death of loved ones’ It w s seen in the case Smith v. Mercy Hospital (2015), that Mrs. Smith underwent a routine surgical procedure at Mercy Hospital. During the surgery, an unexpected complication arose, resulting in Mrs. Smith's death. Following her death, her family members experienced significant emotional distress and psychological trauma. Despite their claims of negligence against the hospital for causing their emotional harm, the court determined that while the family's emotional distress was understandable, the hospital could not be held liable as the complication that led to Mrs. Smith's death was unforeseeable and beyond the hospital's control. A similar situation arose in the case of Doe v. Regional Hospital (2019)", in which Mrs. Doe underwent surgery at Regional Hospital. Due to unforeseen complications during the procedure, Mrs. Doe suffered severe injuries and later passed away. Following her death, her family members, including her children, experienced significant emotional distress and B _ psychological trauma. The court determined that while the family's emotional distress was genuine, the hospital had provided appropriate medical care to Mrs. Doe, and her injur Were an unfortunate consequence of the surgery. Therefore, the hospital could not be held liable for the emotional distress experienced by Mrs. Doe's family members. S In conclusion, the Hospital should not be held liable for the nervous shock experienced by Vineeta due to her father’s condition due to the absence of a duty of care, lack of foreseeability, intervening causes, lack of direct causation, limited duty to third parties, and broader public policy considerations. confirms/5118377 article 1° Smith v. Mercy Hospital (2015) \! Doe v. Regional Hospital (2019)\Gecmeen ee) THE LIGHT OF THE ARGUMENTS ADVANCED AND AUTHORITIES CI E ACCUSED HUMBLY PLEADS BEFORE THE HON’BLE COURT TO: ‘Dismiss the plaintiff's claim against SNS Hospital, with costs, on the grounds that the hospital diligently provided medical care to Mr. Rakesh in accordance with accepted standards of care, and any adverse outcomes were unforeseeable complications rather than a result of negligence on the part of the hospital. Additionally, may the court grant any further relief deemed just and equitable in the circumstances.’ ANY OTHER ORDER AS IT DEEMS FIT IN THE INTEREST OF EQUITY, JUSTICE AND GOOD CONSCIENCE. FOR THIS ACT OF KINDNESS, THE ACCUSED FACTION SHALL BE DUTY-BOUND FOREVER. s (COUNSEL FOR THE ACCUS?