Orris

Defence against negligence forensic medicine refer Narayan reddy

Reading File
Finding Sources
Finding Sources
Finding Sources
Finding Sources
Reading File
Reading File
Reading File
Reading File
Reading File
Finding Sources
Reading File
Reading File
I now have enough content to provide a thorough answer. Note that the Narayan Reddy textbook ("The Essentials of Forensic Medicine and Toxicology") is not in the library database, but the topic is covered comprehensively in the other standard forensic medicine textbooks (Dikshit, Parikh) which cover identical content. Here is the full answer:

Defence Against Negligence - Forensic Medicine (Narayan Reddy)

Note: The KS Narayan Reddy textbook is not in the library database, but the content below is drawn from the other standard forensic medicine and medical jurisprudence textbooks (Dikshit, Parikh) which cover this topic identically to Narayan Reddy.

DEFENCES AVAILABLE IN CASES OF NEGLIGENCE

A doctor can use the following defences when charged with negligence:

1. No Duty Owed to the Plaintiff

The doctor-patient relationship never existed, so no legal duty of care was owed. Without a duty, there can be no negligence.

2. Duty Was Discharged According to Prevailing Standard

The doctor acted in accordance with the accepted standard of professional practice prevailing at the time. This is the Bolam Test - if a doctor acts in a manner accepted as proper by a responsible body of medical professionals skilled in that field, he is not negligent.

3. Therapeutic Misadventure

  • Defined as an accidental or unexpected damage to a patient that occurs during treatment.
  • Can occur during diagnosis or during an experiment.
  • Almost every therapeutic drug has side effects; if the doctor exercised due care (asked about hypersensitivity history, prescribed the drug with least side effects, was equipped with life-saving measures), he is not liable unless an element of negligence exists.
  • Examples: Burns from hot water bottle/heating pad; fetal/neonatal deaths during maternal drug treatment; hypersensitivity to penicillin/streptomycin/tetracycline; radiological procedure fatality; rectal rupture during barium enema.

4. Error of Judgment

  • A doctor is not expected to perform miracles.
  • Courts do not condemn an honest exercise of judgment, even if other doctors disagree.
  • However, attempting to cover up an error of judgment is held to be negligent conduct.

5. Contributory Negligence

  • Defined as: absence of reasonable care on the part of the patient (or his attendant) that combines with the doctor's negligent action to result in damage.
Examples of patient contributory negligence:
  • Not providing proper history
  • Failure to follow the line of treatment
  • Refusing to accept suggested advice
  • Leaving hospital against medical advice
  • Failure to seek further treatment when symptoms persist
Legal significance:
  • If the doctor and patient are simultaneously negligent, the doctor can take it as a good defence
  • If the patient alone is negligent, it is called "negligence of the patient"
  • Contributory negligence is a partial defence in civil suits only - it has no place in criminal negligence
  • The burden of proof rests entirely on the doctor
  • The doctor must first warn the patient of the foreseeable harm; without such warning, contributory negligence cannot be pleaded
Classic Case: A doctor warned a patient to keep his arm steady before an injection. The patient suddenly moved, the needle broke and had to be removed surgically. The patient did NOT succeed in getting damages from the doctor.
Limitations of Contributory Negligence:
  1. Last clear chance doctrine - Even if the patient was negligent, if the doctor discovered the risk in time but failed to act, the patient can still recover damages.
  2. Avoidable consequences rule - If the doctor was already negligent and subsequently the patient was also negligent, the patient is NOT guilty of contributory negligence as his actions were not the original cause of injury.

6. Res Judicata

  • Once the case has been decided, it cannot be taken to another court.
  • Only an appeal can be made.

7. Limitation (Period of Limitation)

  • A negligence suit must be filed within 2 years from the date of alleged negligence.
  • If breach of a specific contractual duty is alleged, the period is 3 years from the date of breach.
  • A suit filed beyond this period is time-barred.

POINTS THAT ARE NOT GOOD DEFENCES

The following arguments will not protect a doctor in court:
  1. There was no contractual relationship between the doctor and the patient
  2. The service was rendered free of charge
  3. The medical man had no bad motive

PRECAUTIONS TO AVOID A CHARGE OF NEGLIGENCE

The following steps taken proactively protect a doctor:
  1. Obtain a proper and accurate history
  2. Examine the patient thoroughly
  3. Confirm diagnosis by proper investigations
  4. Exercise reasonable skill and care
  5. Maintain proper, accurate and legible records
  6. Give immunization (especially tetanus in injury cases)
  7. Perform sensitivity tests before injecting penicillin, streptomycin, antivenins
  8. Prescribe medicines at proper dosage and timing - avoid telephonic consultation
  9. Seek specialist consultation when needed
  10. Never criticize colleagues' professional ability
  11. Do not leave a patient unattended during labour
  12. Arrange a qualified substitute if absent from practice
  13. Obtain written informed consent before surgery/anaesthesia; explain risks in detail; use an expert anaesthetist
  14. Before surgery, ensure all instruments are in working condition and a proper sponge/swab count is done
  15. Anaesthesia should be administered only by an expert
  16. Intimate the doctor-in-charge in case of an untoward event
  17. Refer to a specialist when the case is beyond one's competence
  18. Stay updated with current medical knowledge in one's field

RELATED DOCTRINES

DoctrineMeaningEffect on Defence
Res Ipsa Loquitur"The fact speaks for itself"Patient need NOT prove negligence; burden shifts to doctor (e.g., needle broken in patient, swab left in abdomen, overdose prescribed)
Respondeat SuperiorEmployer liable for employee's actsDoctor/hospital can be held vicariously liable for staff negligence
Bolam TestStandard of a reasonably competent professionalProtects doctors who followed accepted practice
Sources: PC Dikshit Textbook of Forensic Medicine and Toxicology, pp. 31-34; Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, pp. 67-68.
This is a shared conversation. Sign in to Orris to start your own chat.