NEW DELHI: The Uttarakhand state consumer commission on August 17 upheld an order holding AIIMS Rishikesh guilty of medical negligence after its medical records repeatedly recorded a patient as HIV positive, while subsequent tests found him HIV negative. The commission said the hospital failed to explain the HIV-positive entries in its records and upheld compensation of Rs 50,000 and litigation costs of Rs 10,000.What was the dispute over the patient’s HIV diagnosis?According to the commission order, the complainant fell ill on July 12, 2014, and consulted a doctor on July 15. He was referred to a higher centre and was admitted to AIIMS Rishikesh the same day. He was discharged on July 16 after being recorded as HIV positive. The complainant later underwent tests at Shri Guru Ram Rai Institute of Medical and Health Sciences and Shri Mahant Indiresh Hospital in Dehradun, where he was found HIV negative.The complainant alleged that the incorrect HIV diagnosis caused him mental and physical agony as well as financial loss. He approached the Haridwar district consumer commission, which in April 2019 directed AIIMS to pay Rs 50,000 as compensation and Rs 10,000 towards litigation expenses. AIIMS challenged that order before the state commission.However, AIIMS denied that it had conducted an HIV test or diagnosed the complainant as HIV positive. It also argued that the complainant had not produced expert medical evidence to establish negligence. AIIMS further questioned whether the consumer commission had jurisdiction and argued that the complainant could not be treated as a consumer because its services were provided free of cost or at negligible charges.The state commission rejected these arguments. It noted that the medical records showed that AIIMS had charged the complainant Rs 270 towards investigation and other charges. It also held that the Haridwar district commission had jurisdiction because the complainant had initially received treatment there before being referred to AIIMS.Why did the commission hold AIIMS responsible?The bench comprising President Kumkum Rani and Member CM Singh found that AIIMS’s own medical records contradicted its claim that no HIV diagnosis had been made. The discharge summary repeatedly recorded the complainant as HIV positive and advised him to seek further HIV treatment.“The discharge summary issued by the appellant – AIIMS, Rishikesh (paper Nos. 51 & 52) specifically records the respondent No. 1 as HIV positive and also advises him to seek further management of HIV,” the commission said.The commission also considered the later medical reports from Dehradun, which showed the complainant as HIV negative. It said the alleged negligence came directly from AIIMS’s own records and, therefore, the hospital had to explain why the patient had repeatedly been recorded as HIV positive.“In the absence of any explanation or supporting documents from the appellant, the District Commission was justified in drawing an adverse inference against it,” the bench held.The commission said an HIV diagnosis must be made with particular care because of the serious medical, social and psychological consequences attached to the disease. It found that AIIMS had failed to establish that the diagnosis recorded in the discharge summary was based on accepted medical protocol.“The repeated recording of the respondent No. 1 as HIV positive in the official medical records without producing any supporting diagnostic material, clearly constitutes the breach of that duty,” the bench further held.The commission further found that the erroneous recording caused the complainant mental agony, social stigma and emotional distress. It held that the three requirements for establishing medical negligence — a duty of care, breach of that duty and resulting injury or damage — were satisfied in the case.The commission then dismissed the appeal and upheld the Haridwar district commission’s April 22, 2019 order. AIIMS was therefore required to pay Rs 50,000 compensation and Rs 10,000 towards litigation expenses to the complainant. The commission did not impose any additional costs for the appeal.
