New Delhi, May 14: The Supreme Court today awarded the highest compensation ever in a medical negligence case in India, Rs 1 crore, to a patient paralysed waist down after surgery.

Prashanth S. Dhananka, who was a 19-year-old student when tragedy struck him in 1990, argued his own case from his wheelchair in the apex court against the Nizam’s Institute of Medical Sciences (NIMS), Hyderabad.

Although legal sources said the award was more than six times the previous Indian record, it is less than half the median award in medical malpractice cases in the US, which stood at $431,000 (Rs 2.14 crore) way back in 2001.

Prashanth, who had demanded Rs 7 crore, described the compensation as “inadequate”. He had told the court his monthly medical bills came to around Rs 1 lakh — a claim the hospital disputed — and that apart from his emotional and physical trauma, he had become invalid for married life.

Compensation awards in medical negligence cases, which start at consumer courts, are rarely paid in India as serial appeals let the cases drag in higher courts. The courts too avowedly tend to give doctors the benefit of the doubt.

NIMS counsel Nirupa Reddy said he would seek a review which, unlike an appeal, would go to the same bench.

Prashanth was an engineering student, specialising in software, when he was admitted to the hospital in September 1990 with unexplained fever.

After diagnosing a benign tumour, institute doctors advised surgery saying the growth could put pressure on the patient’s respiratory, cardiovascular or neurological systems, or turn malignant some day. Following surgery, Prashanth developed paraplegia — paralysis of the legs and the lower portion of the body.

Six months after his discharge, his father, a Bhel employee, wrote to the institute in November 1991, alleging negligence. In 1993, Prashanth moved the National Consumer Disputes Redressal Commission and sought about Rs 5 crore in damages.

The commission held the institute negligent since it had not included a neurosurgeon in the surgery team or taken the opinion of sister institutes. It awarded Rs 15.5 lakh in compensation.

The institute appealed against the verdict and the patient too challenged the compensation as inadequate, raising the demand to Rs 7 crore. The case reached the Supreme Court in 1999.

The court agreed that Prashanth — now an Infosys employee — had lost out on future income, had had a brilliant career cut short and faced huge medical bills for life, and that his whole family had paid “an enormous price, physical, financial and emotional”. Still, it said, the claim of Rs 7 crore was exaggerated and unreasonable.

But Roger Bennett, a Baltimore-based attorney who specialises in medical malpractice in the US, said: “This figure (Rs 1 crore) would be totally insignificant if the paralysis has been truly caused by medical negligence.”

One New York-based law firm says on its website that it recovered $6.6 million (Rs 32.8 crore) in a case in which a 37-year-old man was left with a permanent deformity in his neck after improper surgeries.

The apex court noted Prashanth’s bravery and dignity in fighting his own case, saying: “Though a sense of deep injury was discernible through his protracted struggle while confined to a wheelchair, he remained unruffled and behaved with quiet dignity, pleading his own case bereft of any rancour or invective for those who in his perception had harmed him.”

“The judgment is heartening and will hopefully pave the way for others,” said NRI doctor Kunal Saha, who has been fighting a case of medical negligence in connection with his wife’s death in a Calcutta hospital in 1998.

With inputs from G.S. Mudur and G.S. Radhakrishna