Achutrao Haribhau Khodwa vs State Of Maharashtra And Ors on 20 February, 1996
Counsel for the Opposite Party Nos. 1 & 2 have also drawn our attention to the literature on medical negligence by Michael A. Jones in Chapter 3, Standard of Care General Principles which clearly states "..... was the defendant careless? In law the test for breach of duty in the tort on negligence is whether the defendant's conduct was reasonable in all circumstances of the case. If it was reasonable he was not negligent ...." He also rolled upon All England Law Report 1957 (2 All ER 118) Bolam Vs. Friern Vs. Hospital Management Committee as well as All England Law Reports (1981) 1 All ER 267-White House Vs. Jordan & Anr., (1985) 1 All ER 643 Sidaway V. Bethlem Royal Hospital Governors & Ors., 1996 (2) SCC 634, Achutrao Haribhau Khodwa & Os. Vs. State of Maharashtra & Ors. It was argued on behalf of the Opposite Party No.3 that they had supplied blood on the request of the hospital for use to the deceased. In all they had supplied 16 units of which 14 were from professional sources and 2 were from non-professional (relations of the deceased). They were all cross-checked and cross-matched as per the guidelines and practice of all blood banks. They were not made aware of any blood reaction at any stage. They came to know first only when notice was received by them from this Commission. According to them the four critical parameters indicative of severe haemolaytic reaction, are as follows: (i) that blood transfusion reaction is immediate, (ii) urine output is severely affected and constantly reduces leading the ultimate renal failure and (iii) there is breakage of red cells and therefore, haemoglobin count of the patient would continuously show a downward trend, (iv) the billirubin count of the patient will show a stead increase and the conjugated (direct) count is always less than unconjugated (indirect) count. As per the evidence on record blood transfusion reaction, if at all there was one, was delayed; it was not immediate. The urine output was normal till about 23rd June and so on. Haemoblogin in this patient on 19th June was 11.8 gms, on 22nd June it was 14.1 gms., 12.8 gms. on 20th June to 14.4. gms on 27th June. The concentration of conjugated billirubin is more than unconjugated billirubin, in normal circumstances. In this case the direct i.e. conjugated billirubin count was found to be more than the indirect i.e. unconjugated billiburin on the two dates i.e. 19th and 26th June, when tests were carried out specifically for the purpose. This alone is sufficient to rule out any haemolytic reaction. All these recorded parameters, do not at all substantiate the main allegation of the Complainant that there was a severe blood transfusion.