1. NEGLIGENCE “Carelessness” or “Not to give proper care”
Conduct without due regard for
the safety of others

2. Law of negligence
applicable to the conduct of all whether professional or layman (Privilege / Obligation)

3. Treatment without proper care
Medical Negligence
Treatment without proper care

4. Scope of Medical Negligence
Ingredients
Duty to act or not to act
Breach of duty
Breach has resulted into a damage

5. Duties of a doctor Care of Patient Presumption
Agreement or implied contract between doctor and patient --- Responsibility to treat
Situations
Private practice
Government employment / others
Emergency room
Termination of duty

6. Duties of a doctor 2. Duty to respond in emergency / night calls
Personal or family physician

7. Duties of a doctor 3. Possession of skill and knowledge
required to treat patient
Commensurate with his claim
General practitioner / specialist
Situations encountered by junior doctors while rendering specialist treatment
When expert / specialist advice available
When expert / specialist advice not available

8. Duties of a doctor 4. Duty to show skill and care
5. Duty to keep himself abreast with recent advances in techniques / procedures and knowledge about drugs
6. Duty to obtain informed consent
7. Duty to maintain professional secrecy

9. Professional Secrecy Arises by virtue of ethical standards accepted in
the medical profession
Three principles:
No disclosure
Partial disclosure
Complete disclosure

10. Privilege Communication
Arises by virtue of legislatively created protections.
Sometimes the public duty overcomes the professional duty and professional secrecy can not be maintained.
Communications made in these situations are called privilege communication

11. Qualified Privilege
Breach of duty is protected if certain conditions are observed
Not malicious
In good faith
To a party having duty to receive it

12. Absolute Privilege
Professional dictates are ignored in Toto as all courts enjoy absolute privilege over all secrets involved between doctor and patient
Nothing said in these circumstances can be used for any action liable or slender

13. Professional Confidence may be broken
With consent of the patient
As a statuary duty laid down by law
By order of the Court / Parliament
In the larger interest of the community

14. Professional Negligence
No statuary definition
Chief Justice Lord Tindal 1838 – Doctor, who has a relationship of professional attendance with a patient, undertakes to practice his profession with a reasonable degree of care and skill and when he fails in this respect, he may have shown professional negligence

15. Doctor’s share of responsibility
Patient’s share of responsibility

16. Ingredients to be proved for medical negligence
Five elements of common law “Tort”— Civil Wrong
Plaintiff’s right to be free from illness (physical / mental)
Defendant’s duty to plaintiff to conform to a standard
Breach of this duty
Breach resulting into damage to plaintiff
Determination of damage in terms of money

17. Patient has to Prove Integrity of his person or part affected
Doctor owe a duty of care to patient
Doctor was in breach of duty by his negligent act
Breach has caused patient to suffer damage
Patient proves the loss / damage in terms of money

18. Res-ipsa-loquitur
Doctrine of common law of negligence – “Thing speak for itself”
Patient has in no way contributed to his
own injury
Instrument causing injury was in sole
control of doctor
Damage would not have occurred in the
absence of negligence

19. Situation in our country
Implicit loyalty of patient to doctor hence no claim for damages – Doubles the responsibility

20. Types of Negligence Criminal Civil Malpraxis 2. Contributory
3. Third party

21. Criminal Negligence
Reckless, wicked attitude showing complete disregard for the safety of the patient’s life culminating into his death “Manslaughter”

22. Civil Negligence
Lack of carefulness while administering treatment

23. Malpraxis Extraction of wrong / healthy tooth
Amputation of wrong / healthy limb
Failure to give anti-tetanus vaccine
following injury causing disease to the
patient
Failure to x ray the fractured part

24. Contributory Negligence
Patient and doctor contribute

25. Third Party Negligence
Paramedic’s
“Master-Servant Doctrine”
“Doctrine of “Respondent Superior” or
“Captain Ship theory”
“Vicarious liability” – Liability without direct
fault
“Borrowed Servant Doctrine”

26. Defense against Allegations of Negligence
Doctrine of “informed consent”
Doctrine of “volunti-non-fit-injuria” -- Assumption of
risk – Patient insists upon the course of treatment in
spite of the fact that doctor was reluctant
Negligence of third party
Contributory negligence or Delegation of duties
(patient’s share of responsibility)