Dr Don Gregory Junior Resident Dept of Chest amp TB I ntroduction The Consumer Protection Act 1986 is a benevolent social legislation that lays down the rights of the consumers and provides their for promotion and protection of the rights of the consumers The first and the only A ID: 555562
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Slide1
CONSUMER PROTECTION ACT
Dr. Don GregoryJunior ResidentDept of Chest & TBSlide2
Introduction
The
Consumer Protection Act, 1986
is a benevolent social legislation that lays down the rights of the consumers and provides their for promotion and protection of the rights of the consumers. The first and the only Act of its kind in India, it has enabled ordinary consumers to secure less expensive and often speedy
redressal
of their grievances. By spelling out the rights and remedies of the consumers in a market so far dominated by organized manufacturers and traders of goods and providers of various types of services, the Act makes the dictum
,
caveat emptor
(‘buyer beware’) a thing of the past.
The
Act mandates establishment of Consumer Protection Councils at the Centre as well as in each State and District, with a view to promoting consumer awareness.Slide3
The Central Council is headed by Minister, In-charge of the Department of Consumer Affairs in the Central Government and the State Councils by the Minister In-charge of the Consumer Affairs in the State Governments. It also provides for a 3-tier structure of the National and State Commissions and District Forums for speedy resolution of consumer disputes.
To provide inexpensive, speedy and summary
redressal
of consumer disputes, quasi-judicial bodies have been set up in each District and State and at the National level, called the District Forums, the State Consumer Disputes
Redressal
Commissions and the National Consumer Disputes
Redressal
Commission respectively.
At present, there are 629 District Forums and 34 State Commissions with the National Consumer Disputes
Redressal
Commission (NCDRC) at the apex. Slide4
Each District Forum is headed by a person who is or has been or is eligible to be appointed as a District Judge and each State Commission is headed by a person who is or has been a Judge of High Court.
The National Commission was constituted in the year 1988. It is headed by a sitting or retired Judge of the Supreme Court of India.
V.
Balakrishna
Eradi
was the
First President of
NCDRC. The National Commission is presently headed by
Hon’ble
Mr. Justice Ashok
Bhan
, former Judge of the Supreme Court of India as President and has ten Members
The provisions of this Act cover ‘goods’ as well as ‘services’. The goods are those which are manufactured or produced and sold to consumers through wholesalers and retailers. The services are in the nature of transport, telephone, electricity, housing, banking, insurance, medical treatment, etc. Slide5
A written complaint, can be filed before the District Consumer Forum for pecuniary value of
upto
Rupees twenty
lakh
, State Commission for value
upto
Rupees one
crore
and the National Commission for value above Rupees one
crore
, in respect of defects in goods and or deficiency in service.
The remedy under the Consumer Protection Act is an alternative in addition to that already available to the aggrieved persons/consumers by way of civil suit. In the complaint/appeal/petition submitted under the Act, a consumer is not required to pay any court fees but only a nominal fee.
Consumer
Fora
proceedings are summary in nature. The
endeavor
is made to grant relief to the aggrieved consumer as quickly as in the quickest possible, keeping in mind the provisions of the Act which lay down time schedule for disposal of casesSlide6
If a consumer is not satisfied by the decision of a District Forum, he can appeal to the State Commission. Against the order of the State Commission ,a consumer can appeal to the National Commission and appeal to the Supreme court against national commission, all being within 30 days of the order.
In order to help achieve the objects of the Consumer Protection Act, the National Commission has also been conferred with the powers of administrative control over all the State Commissions by calling for periodical returns regarding the institution, disposal and pendency of cases.
Functioning of District Forum, State Commission and National Commission is consumer friendly, and thus a consumer can file a complaint and also address arguments in person. Slide7
The National Commission is empowered to issue instructions regarding
(1) adoption of uniform procedure in the hearing of the matters
(2) prior service of copies of documents produced by one party to the opposite parties
(3) speedy grant of copies of documents, and
(4) generally over-seeing the functioning of the State Commissions and the District Forums to ensure that the objects and purposes of the Act are best served, without interfering with their quasi-judicial freedom.
The Registry of the National Commission is at INA, New Delhi
It remains open on all working days.
The filing timings are from 10.00 a.m. to 4.30 p.m.
Every matter filed with the Registry is listed on the 7
th
day of its filing for admission before the National Commission.
In genuine cases where the complainant/ appellant/ petitioner before the National Commission is unable to engage the services of an advocate, legal aid is provided by the Commission free of charge.Slide8
DEFINITIONS
1)Complainant
(
i
) a consumer
(ii) any voluntary consumer association registered under the Companies Act,1956
(iii) the Central Government or any State Government
(iv) one or more consumers, where there are numerous consumers having the same interest
(v) in case of death of a consumer, his legal heir or representative Slide9
2)
Complaint :any allegation that includesAn unfair trade practice Restrictive trade practice (manipulation of price or conditions/delay)
Defective goods
Deficiency of services
Trader or the service provider has charged for the goods or for the services mentioned in the complaint, a price in excess of the price- Fixed by or under any law for the time being in force /displayed on the goods or any package containing such goods/displayed on the price list exhibited by him by or under any law for the time being in Force/agreed between the parties
Goods which will be hazardous to life and safety when usedSlide10
3)
Consumer: any person whoBuys any goods for a consideration which has been paid or promised or partly paid and partly promised, or under any system of deferred payment
Hires or avails of any services for a consideration which has been paid or promised or partly paid and partly promised, or under any system of deferred payment
Does not include a person who obtains such goods for resale or for any commercial purpose
4)
Person
: includes
(
i
) a firm whether registered or not
(ii) a Hindu undivided family
(iii) a co-operative society
(iv) every other association of persons whether registered under the Societies Registration Act, 1860 or notSlide11
5)
Defect : Any fault, imperfection or shortcoming in the
quality, quantity, potency, purity or standard
which is required to be maintained by or under any law for the time being in force
Under any contract, express or implied or] as is claimed by the trader in any manner whatsoever in relation to any goods
6)
Deficiency:
Any fault, imperfection, shortcoming or inadequacy in the
quality, nature and manner of performance
which is required to be maintained by or under any law for the time being in force or has been undertaken to be performed by a person in pursuance of a contract or otherwise in relation to any serviceSlide12
7)
Service :meansService of any description which is made available to potential users and includes the provision of facilities in connection with banking, financing insurance, transport, processing, supply of electrical or other energy, board or lodging or both, entertainment, amusement or the purveying of news or other information
Does not include the rendering of any service free of charge or under a contract of personal service
Medical services are covered under the definition of "service". Service includes rendering of consultation, diagnosis and treatment, both medical and surgical
NOTE:
CPA is amended
in 1991, 1993 and 2002Slide13
CPA has been made applicable to “all goods and services” .Two types of services have categorically been kept out of the purview of this Act. These are:
Services rendered free of charge;
and
Services rendered under a contract of personal service.
"Contract of personal service" has to be distinguished from a "contract for personal service“.
Wherever, there is relationship like that of master and servant it is a "contract of personal service" and is excluded from the purview of the Act
In the absence of relationship of master and servant between the patient and the medical practitioner, the service rendered by a medical practitioner to the patient cannot be regarded as service rendered under a contract of personal service. It is "contract for personal services". Slide14
RIGHTS OF A CONSUMER
The right to be protected against the marketing of goods and services which are hazardous to life and property; The right to be informed about the quality, quantity, potency, purity, standard and price of goods so as to protect the consumer against, unfair trade practices;
The right to be 'assured, wherever possible, access to a variety of goods and Services at competitive prices;
The right to be heard and to be assured that consumer's interests will receive due consideration at appropriate
Fora
;
The right to seek
redressal
against unfair trade practices 3[or restrictive trade practices or unscrupulous exploitation of consumers; and
The right to consumer educationSlide15
Who can file a complaint?
1. An individual consumer
2. Recognized consumer bodies
3. A group of consumers with same interest
4.Central or State Governments.
Who cannot file a complaint?
1.Complaint by an individual on behalf of general public
2.An unregistered association cannot file a complaint
3.After expiry of limitation period
Time limit to file a complaint?
Within two years from the date on which the cause of action has arisenSlide16
Filing a case
Sl
No
Total value of goods or service and the compensation claimed
Amount of fee payable
1)
District Commission
Upto
one
lakh
rupees – For complainants who are under the Below
Proverty
Line
NIL
Upto
Rs.10,000/-
NIL
Upto
one
lakh
Rupees – For complainants other than
BPL
Rs.100/-
Above five
lakh
and
upto
ten
lakh
rupees
Rs.1000/-
Above ten lakh and upto twenty lakh rupees
Rs.2000/-
2) State
Commission
Above twenty
lakh
and
upto
fifty
lakh
rupees
Rs.5000/-
Above fifty
lakh
and
upto
one
crore
rupees
Rs.10,000/-
3) National Commission
Above one
crore
rupees
Rs.25,000/-
Above five
crore
rupees
Rs.50,000.-
Above ten
crore
rupees
Rs.1,00,000/-Slide17
CONSUMER COMPLAINT
The Consumer Complaint along with all the copies should be paginated and duly indexed in the following seriatim:-
1. Index
2. List of Dates
3. Memo of Parties (with fresh complete addresses)
4. Complaint with Notarised attested affidavit
5. Supporting documents in favour of complaint e.g. receipt, voucher etc. (All the
Annexures
must be attested as True Copy on the last page with name & signature)
6. Application for
condonation
of delay with Notarised attested affidavit, if beyond limitation. (
2 years from cause of action
)
7. Fee for making Consumer Complaint (In the form of Demand Draft)
Note: CPA extends to the whole of India except the State of Jammu and Kashmir.Slide18
Name of Agency
Cases filed since inception
Cases disposed of since inception
Cases Pending
% of total Disposal
National Commission
80014
69253
10761
86.55
State Commissions
600097
504834
95263
84.13
District Forums
3242324
2994256
248068
92.35
TOTAL
3922435
3568343
354092
90.97Slide19
Some Implications of the Act
Persons buying goods either for re-sale or for use in large scale profit making activity will not be `consumers’
The insurance company is not a consumer.
A lottery ticket holder is not "consumer“
Applicant who merely applies for allotment of shares is not a consumer
If somebody does not perform his part of the contract, it amount to deficiency in service
Undue delay in declaration of examination result is obviously deficiency in service
The student is a consumer of service of educational instituteSlide20
When the case is not a simple case of deficiency in service and involves determination of complex questions of facts and law, which cannot be satisfactorily determined by the
redressal
agency .In the time frame provided under the Rules, it would be better for the complainant to seek
redressal
of his grievances in a Civil Court
If "fraud" is alleged, it is desirable that the complainant should be directed to Civil Court as investigation about such fraud is required to be done
The party to be awarded compensation has not only to show deficiency in service but also the negligence of the other party and without the finding of negligence there cannot be any awardSlide21
RELIEF THAT MAY BE AWARDED BY CONSUMER FORUM
Award compensation for loss or injury suffered due to negligence; and/or order opponent to
Remove deficiency in service
Discontinue the unfair trade practice
Pay sum towards loss or injury suffered by large number of people
Provide for adequate cost to partiesSlide22
CPA For Professionals
CPA is not in derogation of any other law. The provisions of this Act shall be in addition to and not in derogation of the provisions of any other law for the time being in force.
All professionals — Advocates, Architects, Chartered Accountants,
Doctors
, Engineers, Interior Decorators and
others are
covered under the Consumer Protection Act, 1986
.
All the professionals are
licenced
and covered under respective laws of the land. So it does not mean that professionals are not liable for due compensation under the Consumer Protection Act for their ‘negligence’ and ‘deficiency’ in service.
A person who receives medical treatment in a Government hospital is not a consumer under the Act; Consumer Unity & Trust Society v. State of Rajasthan, (1991) I CPR 241.
However, the State Commission of Orissa held that a patient is a Consumer being the beneficiary of services in as much as the State Government is paying the consideration amount in the form of salary to the doctors
aI
)d hospital staff; Smt.
Sukanti
Behera
v. Dr.
Sashi
Bhusan
Rath
, II (1993) CPJ 633.Slide23
MEDICAL NEGLIGENCE AND CONSUMER PROTECTION LAW
Negligence is the breach of a duty caused by omission to do something which a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do.
For medical negligence of any kind to be proved it must be shown that:
1) The defendant (doctor) owed a duty of care to the plaintiff.
2)That the defendant was in breach of that duty.
3)That the plaintiff suffered damage as a result
which can be measured and compensated for in terms of money
.Slide24
No doctor is expected to possess all current medical knowledge or being able to apply all known diagnostic or therapeutic techniques but a doctor of a particular standing as regards to his degree and experience is expected to have a standard of knowledge and capability commensurate with his status.
Medical Negligence can only occur when a doctor-patient relationship is established. A doctor is not negligent if he does not offer his services in an emergency to a person.
Burden of proof lies with the complainant. He has to provide Higher standard of evidence to support an allegation of negligence against a doctor & establish his claim.Slide25
Some acts that amounts to medical negligence
Failure to attend the patient
Not attending complicated delivery
Not revealing HIV positive status
Unfitting dentures
Injections/ drugs wrongly given
Foreign body in the abdomen
Failed
tubectomy
operation
Perforation of uterus
Contaminated blood transfusion
Res
ipsa
loquitourSlide26
WHAT THE LAW SAYS?????
Any professional does
not assure his client of the result
.
The only assurance which
he
can give or can
be understood
to have given by implication is that he is possessed of the requisite skill
in that
branch of profession which he is practising and
while undertaking
the
performance of
the task entrusted to him he would be exercising his skill
with reasonable competence.
Judged
by this standard, a professional may be held liable for negligence on one of
two findings
: either he was not possessed of the requisite skill which he professed to
have possessed
, or, he did not exercise, with reasonable competence
/care in
the given
case
.Slide27
A
mere deviation from normal professional practice is not necessarily evidence
of negligence
. Let it also be noted that a mere accident is not evidence of negligence.
So also
an error of judgment on the part of a professional is not negligence per se.
Higher the
acuteness in emergency and higher
the complication
, more are the chances of
error of
judgment
.
So long as it can be found that
the procedure
which was in fact adopted was one which was acceptable to medical
science
as on that date, the medical practitioner cannot be held negligent merely because
he chose
to follow one procedure and not another and the result was a
failure.Slide28
No sensible professional would intentionally commit an act or omission
which would
result in loss or injury to the patient as the professional reputation of the person
is at
stake. A single failure may cost him dear in his career.
Even
in civil jurisdiction,
the rule
of res
ipsa
loquitur
is not of universal application and has to be applied
with extreme
care and caution to the cases of professional negligence and in particular
that of
the doctors. Else it would be counter productive.
Simply
because a patient has
not favourably
responded to a treatment given by a physician or a surgery has failed,
the doctor
cannot be held liable per se by applying the doctrine of res
ipsa
loquitur
.Slide29
A medical practitioner faced with an emergency ordinarily tries his best
to redeem
the patient out of his suffering. He does not gain anything by acting
with negligence
or by omitting to do an act. Obviously, therefore, it will be for
the complainant
to clearly make out a case of negligence before a medical practitioner
is charged
with or proceeded against criminally
.
If the hands be trembling with the dangling fear of facing a criminal prosecution in the event of failure for whatever reason - whether attributable to himself or not, neither a surgeon can successfully wield his life-saving scalper to perform an essential surgery, nor can a physician successfully administer the life-saving dose of
medicineSlide30
Discretion being
better part of valour, a medical professional would feel better advised to leave
a terminal
patient to his own fate in the case of emergency where the chance of
success may
be 10% (or so), rather than taking the risk of making a last ditch effort
towards saving
the subject and facing a criminal prosecution if his effort fails. Such
timidity forced
upon a doctor would be a disservice to the society
.
The purpose of holding a professional liable for his act or omission, if negligent, is to make the life safer and to eliminate the possibility of recurrence of negligence in future.Slide31
Some Interesting Cases
1)Indian Medical Association v. V.P.
Shantha
and Ors. (1995) 6 SCC 651
A
three-Judge
Bench decision.
The principal issue which arose for decision by the Court was whether
a medical
practitioner renders 'service' and can be proceeded against
for 'deficiency in service
' before a forum under the
CPA.
The
Court dealt
with how
a 'profession' differs from an 'occupation' especially in the context of
performance of
duties and hence the occurrence of negligence.
The
Court noticed that
medical professionals
do not enjoy any immunity from being sued in contract or tort (i.e. in
civil jurisdiction
) on the ground of
negligence.Slide32
2)
Poonam
Verma
v.
Ashwin
Patel and Ors., (1996) 4 SCC
332
A doctor registered
as medical practitioner and entitled to practice in Homoeopathy
only, prescribed
an allopathic medicine to the patient. The patient died
.
The doctor was
held to
be negligent and liable
to compensate
the wife of the deceased for the death of
her husband
on the ground that the doctor who was entitled to practice in
homoeopathy only
, was under a statutory duty not to enter the field of any
other system
of
medicine and
since he trespassed into a prohibited field and prescribed the allopathic
medicine to the
patient causing the death, his conduct amounted to negligence per se actionable
in civil law.Slide33
3)
Bolam
vs.
Frien
hospital management
committee (1957)
Mr.
Bolam
was advised
ECT
for mental
illness.He
was however,
not warned
of the risks of fractures involved in
the treatment
.
There
were two bodies of opinion.
One preferred
the use of relaxant drugs. Using
relaxants, the
patient sustained dislocation of both hip
joints with
fracture of pelvis
.
The supreme court
held that
the doctor was not negligent because he
acted in
accordance with practice accepted as proper
by a
responsible body of medical men skilled in
that art
.
The ‘
Bolam
’ principle implies that a doctor
is not
negligent if he acts in accordance with a
practice accepted
at the time as proper in diagnosis
and treatment
but also to advice and warning by
a “responsible
body” of medical opinion even
though other
doctors adopt a different practice
.
A doctor
is not
liable for taking one choice out of two
for favouring
one line of treatment rather than another.Slide34
4)
Tarun
Kumar
Pramanik
vs. Dr.
Kunal
Chakraborty
& Ors, 1995(2) CPR
545(WE SCDRC
)
The complainant alleged that during
operation for
left inguinal hernia his left testis was
removed negligently and without
consent. On account of
this suffered
and has become handicapped.
The State Commission
on the basis of evidence placed
on record
, and opinion of expert witness held that
the removal
of testis was done of expert witness
held that
the removal of testis was done to
avoid gangrenous
infection, operation was done
with reasonable
care and skill and had not resulted
in any
handicap
.
Complainant was held to be
vexatious and
complainant liable to pay cost of 1st
opposite party
.Slide35
5)P
.
Sudhakar
Vs.
Gowri
Gopal
Hospital,
2004(1
) CPJ 329 (AP SCDRC)
Surgery was done for acute
appendicitis.
During the
post operative
period, the
patient expired
after administration
of wrong drug”
Fancuran
Bromide
,2ml
,mistaking it for analgesic
.
As compensation Rs
. 2
lac
was awarded along with Rs.10,000 as
costs for OP-hospital.
D
octor
and nurse were held
jointly liable
.Slide36
6)
Jasbir
Kaur
v State of Punjab,
AIR 1995 P&H
278
In
Shri
Guru
Teg
Bahadur
Hospital, Amritsar ,
newly born
baby was missing from the
bed
Later
on the child was found in profusely
bleeding condition
and with one eye totally gouged out with the eyeball, near the wash basin of the
bathroom.
H
ospital
authorities contended the mischief of
cat which
caused
damage.
D
efendants
were held
liable.
Compensation was awarded to petitioners
to the extent of rupees
one
lakh
for negligence, callousness and carelessness of the
respondents.Slide37
7)
In
Md.
Aslam
v/s Ideal Nursing Home and Ors., 1986-99 Consumer 4233 (NS)
National Commission held as follows: ‘
Death of a patient due to infection after operation and Medical Negligence was alleged. No negligence on the part of the Nursing Home or the Doctors attending the patient-patient did not follow the advice given to her-appeal dismissed
’
8)
In
Narasimha
Reddy & Ors. v.
Rohini
Hospital &
Anr
. I(2006)
CPJ144(NC)
,National
Commission held that where a patient could not be operated due to critical condition, doctor can not be held guilty of negligence if proper course of practice is adopted and reasonable care is taken in administration of treatment. Consequently the Revision petition filed by Complainant was dismissed
.Slide38
9)In
Nihal
Kaur
v/s Director, P.G.I.M.S.R. III (1996) CPJ
112
where a patient died a day after surgery and the relatives found a pair of scissors utilized by the surgeon while collecting the last remains, a compensation of Rs. 1.20
lakhs
was awarded by the State Commission, Chandigarh on the grounds that negligence was writ large on record in handling the case though it was argued that arterial forceps and sponges were left behind in an attempt to save the life of the patient and (the said things were to be later removed, but could not be done as the patient died) the same did not contribute to patient’s
death.Slide39
10)In the case Mrs
.
Shantaben
Muljibhai
Patel & Ors. v. Breach Candy Hospital and Research Centre & Ors. I(2005) CPJ 10 (NC
)
,National
Commission held that doctors are required to take risk while performing their job and merely because a patient dies to certain accidental eventualities does not establish deficiency in service or negligence on the part of a doctor or a
hospital.Slide40
How to avoid litigations?
1. Personal level2. Practice level.3. Professional indemnity
4. Support groups
5. Defences
A.
Technical.
B.
Factual.Slide41
Personal level
A doctor should have M.C.I. approved qualification,
Training and experience of recognized centres.
The prescription heads, signboards and advertisements should mention the actual facilities available for diagnosis and treatment.
The doctor should have a sympathetic attitude towards patients and answer all queries without losing temper.
He should refrain from claims of guarantee of results.
He should keep himself updated of the latest development by attending CME’s, workshops and academic sessions.Slide42
Practice level
Exercising reasonable medical, social and legal skill and care in diagnosis and treatment,
Proper documentation of facts and legally
valid informed consent.
This can be done by making good clinical notes of findings on examination and treatment given.
Where there is failure to follow instruction, refusal for any investigation and failure to come for review on specified date should always be recorded in underlined way.
These negative records act as important tool while defending our cases in court of law
.Slide43
Professional indemnity
Indemnity by the insurance companies gives a sense of mental security to the doctor/hospital and if any medical negligence is proved ,the company takes care of it.
Support groups
By forming societies like the Indian Medical Association, Medical college teachers Welfare Society, doctors not only get a type of social security but regular fellowship will prohibit the doctors speaking foul against their own colleague.
Such forums can be used from time to time for discussion of various provisions of acts, cases fought and their results and the lessons to be learned from them.Slide44
DEFENCES
Doctors/Hospitals should always make all possible points in defence in first instance of making a reply to the complainant.
Technical Defences
Concurrent adjudication in another court.
The court does not have pecuniary/territorial jurisdiction.
Complaint is time-barred.
Complicate issues involved, required recording of evidence of experts, hence case should relegated to a civil court. Such a plea must be taken at the beginning of the trial.
The complaints frivolous and vexations and liable to be dismissed under section 26 of the Act and may be fined
upto
Rs 10000
Inform your insurance company in writing with a copy of the complaint
.Slide45
B. Factual defences
Mention your qualifications,
training,experience
, expertise etc. Support with relevant documents.
2.Mention hospitals infrastructure
facilities,special
facilities, back-up support, it with documents.
3. Complainant has not come to the court with clean hands i.e. he has suppressed material facts, e.g. previous illness, treatment etc.
4. Inconsistence between notices sent directly or through consumer groups and the complaint made in the court.
5. Written evidence of consent of the patient/ relative/attendant to assumption of inherent and special risks in the treatment.Slide46
6. Circumstances of the case; viz. There was emergency, lack of facilities (e.g. rural area) no one to give history of patient’s illness etc.
7. Burden of proof of: (
i
) duty of care; (ii)breach of that duty; (iii) causation; (iv)damage, etc. Is on the complainant.
8. Reasonable knowledge, skill and care exercised (Rely/quote standard text books with attested photocopies).
9. Consolation/treatment by patient from other doctor/other systems of medicine simultaneously.
10. Many other reasons/more than one reason/for occurrence of damage.
11. Contributory negligenceSlide47
TO CONCLUDE….
After the consumer protection act has included the medical professional in its ambit, it has proved to be double-edged sword for a doctor.
Only proper and ethical judgement , precautions and proper documentation of all facts of the patient details, diagnostic tests and treatment given and informed consent from the patient or his guardian can save a doctor against any litigation.
The relationship between Doctor/Hospital and Patients is a relationship of trust; doctors are still known as healers!
There is no real alternative!!
Let not commercialization destroy the edifice of medical practice!!!Slide48Slide49