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Cases in the grey area between negligence and manslaughter need more attention

On a day when one reads about the humanity of the late Justice Krishna Iyer and then reads about man’s inhumanity to man, it upsets the mind. In the case we read, the victim was just a child; the pain compounded.

Harjol Ahuluwalia, a kid, had taken ill. He did not respond to the local doctor’s medicine while being treated in a Noida nursing home. The parents were advised to shift the child to a hospital. They did.

Harjol was suffering from typhoid; that is what the doctor said. Blood tests, cultured, can determine typhoid. The details are not reported but one has to take the doctor’s word as gospel. Harjol was duly admitted as an inpatient; an obvious sign of a serious condition.

Readers will recall how mix-ups occur in a hospital. In Harjol’s case, as presented to the National Consumer Disputes Redressal Commission at Delhi, the child was advised certain medication. The nurse attending on the child gave a slip of paper to the boy’s parents andasked them to get the prescribed medicine. The name given for the drug was Lariago.

At this point, the case gets murkier. Lariago is an anti-malarial compound. Quinine-based, its generic formula is chloroquin or quinine hydrochloride. Quinine is the most effective medicine against malaria, especially the parasite plasmodium vivax. It is a mild drug, taken in pill form over days. In fact, it is used by some, in minute doses, as a prophylactic.

Nowhere is it prescribed as an anti-typhoid formulation.

In severe malaria cases, medication is injected for greater relief. It is, of course, to be administered with care and under constant supervision. Harjol was given a shot.

The boy immediately collapsed… in his mother’s arms. All hell broke loose. Experts were called in, including the paediatrician. Oxygen was supplied through a manual respirator. No improvement. The platelet count in the blood started to fall. More panic.

The hospital authorities gave up and suggested an immediate transfer to the intensive-care unit of a major hospital, automatic ventilators being available there. The child was shifted to the All India Institute of Medical Sciences (AIIMS).

A few days later, with no improvement in sight, other than the physical condition being stable, the boy was discharged. Unfortunately, he was in a vegetative state and the doctors at AIIMS said he would remain so permanently. The only son of his grieving parents, Harjol was condemned for life; his brain damaged.

The previous hospital offered to treat Harjol, but everyone must have realised that it was a lost battle. The attending nurse, who administered the injection, was not even qualified. The parents sued.

Now you be the judge.

All sympathy would be for the boy, naturally. But people do not give up so easily. The parents asked for Rs28 lakh, just to see the child through his life. The hospital baulked.

The insurance company said that it would not pay and, even if they had to, the maximum amount could be Rs12.5 lakh, the amount that the hospital was insured for.

Next was the excuse that the child was not a consumer; that the treatment was free.

Excuses galore. Finger pointing at its worst.

Litigation cannot end on a happy note. Why just medical negligence? This was equivalent to manslaughter. Homicide. Can monetary compensation ever come near the grief of the parents and the torture inflicted on the boy for life?

The Commission upheld the payment of Rs12.5 lakh as cover and another Rs5 lakh as additional relief. The question that begs an answer is: Was it worth fighting the poor folk for years, knowing fully well that they were bound to be compensated?

Surprisingly, no one ever asked why Lariago was administered in the first place.

Chloramphenicol was a drug of choice against typhus at one time! Now it is antibiotics.

Doctors are known for bad handwriting. Was this one such case?

Bapoo Malcolm is a practising lawyer in Mumbai. Please email your comments to mail@moneylife.in 

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