The Telegraph
Wednesday , February 12 , 2014
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Guess why docs want a cap

New Delhi, Feb. 11: The Indian Medical Association, a body of 240,000 doctors, has joined Calcutta’s AMRI Hospitals in seeking a review of the record compensation awarded by the Supreme Court to NRI physician Kunal Saha for his wife’s death from medical negligence.

The Indian Medical Association (IMA) has also called for a cap on the amount of compensation that can be awarded in cases of medical negligence.

One of the reasons the association has cited is that such rulings may scare students off the medical profession.

Last October, the Supreme Court had awarded Saha Rs 6.08 crore as compensation for Anuradha Saha’s death in 1998 from medical negligence by doctors at AMRI Hospitals and imposed an additional Rs 5.47 crore as interest.

Senior IMA officials today announced the organisation had joined the review petition filed by AMRI Hospitals questioning the quantum of compensation it has been ordered to pay amid concerns in the medical community that it would become a “trendsetter”.

“We believe this compensation of (Rs) 11 crore is unjustified and could financially hurt patients across the country,” said Narendra Saini, the secretary-general of the IMA, a private body that claims a membership of more than a third of India’s estimated 600,000 MBBS-qualified doctors.

The threat of large compensations may push doctors into ordering unnecessary diagnostic tests, delaying medical decisions even in emergency situations, said IMA president Jitendra Patel.

Doctors, Saini said, may also pass on the costs of insurance premiums against the risk of negligence liability to patients, increasing the cost of health care.

Three in four hospitals across India are small nursing homes run by a single doctor or a small group of doctors, IMA officials said.

“These small nursing homes make up the backbone of hospital-based care in India,” Saini said. “And such huge compensations will force them to shut down.”

An IMA release today claimed that such judgments may even “frighten students” away from joining the medical profession. But two senior doctors said such a claim shouldn’t be taken seriously.

“Have the huge compensations in the US deterred medical school admissions?” said a paediatrician in New Delhi who asked not to be named. “No, they have not.”

“The amount of compensation should depend on the type of hospital — a not-for-profit institution should not have to pay the same as a corporate hospital,” said Abhay Shukla, a Pune-based physician with a non-government public health organisation, Cehat-Saathi.

Saha, who has already received Rs 4 crore from AMRI Hospitals, said he was not surprised by the IMA’s position.

“They want caps on compensation amounts,” he told The Telegraph over the phone from Columbus, Ohio. “Are there caps on the amounts doctors and hospitals charge their patients?”

Saha added: “Many families in India have been destroyed by the fees charged by hospitals.”

The IMA has claimed that several US states have imposed caps lower than Rs 11 crore on compensation for medical negligence.

But Saha said this was a misleading assertion because, while some states in the US had imposed caps on non-economic damages (compensation for pain or suffering), no state had imposed caps on economic damages, or the compensation for direct loss of income.

“Nearly 95 per cent of the compensation in Anuradha’s case is for loss of income,” Saha said.

Medical malpractice cases in the US have often involved comparable amounts.

The website of a US-based lawyer specialising in medical negligence cites the example of a $3 million (Rs 18.6cr) settlement in a case involving obstetrical malpractice and a settlement of about $1 (Rs 6.2cr) million in a case of meningitis.

Another law firm in the US engaged in medical malpractice cases has cited a $2.8 million (Rs 17.4cr) settlement involving the death of a man because of a failure to diagnose and treat sepsis, and a $2.1 (Rs 13cr) million settlement because of a failure to administer the right drugs, resulting in death.

The Supreme Court had computed the compensation in the Saha case by factoring in the earnings of Anuradha to be $40,000 per year, adding 30 per cent to cover future pay rises, deducting one-third of this sum as her personal expenditure, and multiplying it by 30, the presumed number of earning years she had left.