JIAFM, 2007 29 (3); ISSN: 0971- 0973

Consumer Protection Act (CPA / COPRA) Related to Medical Profession

* Dr. Chandra Prakash, ** Dr. S. K. Roy Chaudhary, *** Dr. Renu Bala, **** Dr. Bhawna Shrivastav,
*****Dr. Abhishek Rai, ***** Dr. Roham
*Assistant Professor,
** Professor & Head,
*** Professor,
**** Assistant Professor, Dept. of Pharmacology, UFHT Medical College, Haldwani
*****Demonstrator,
Dept. of Forensic Medicine, UFHT Medical College, Haldwani
Correspondence:
Dr. Chandra Prakash, Assistant Professor, dept. of Forensic Medicine, UFHT Medical College,
Haldwani (Nainital) Uttarakhand.
Abstract
With the fast pace of commercialization and globalization on all spheres of life, the medical profession is no
exception. Since the passing of the Consumer Protection Act in 1986, the doctor-patient’s relationship has
deteriorated significantly and litigation against doctors is increasing day by day. This review article enlightens
medical practitioners regarding Consumer Protection Act and how to prevent litigations.
Key Words: Consumer Protection Act, Professional negligence, Complainant, Complaint, Consumer, Service

Introduction: Usually complaint should be decided within 90 days

The Doctor patient relationship in our country has from the date of notice issued to the opposite party.
undergone a sea change in the last decade and a Where sample of any goods is required to tested,
half. The fortunate doctors of the past were treated case may be disposed within 150 days or it may take
like God and earned respect. Commercialization and more time due to practical problems. The complaint
globalization on all spheres of life has not even should be filed in the District forum, State
spared the medical profession as well. As a result, commission or National Commission within two years
the doctor-patients relationship has deteriorated from the date on which the cause of action has
considerably. Earlier too, doctors were covered by arisen. In case there is sufficient ground for not filing
various laws, i.e. the Law of Torts, IPC etc., but since the complaint within such period delay may be
the passing of the Consumer Protection Act in 1986, condoned at the discretion of the consumer
litigation against doctors is on the increase. forum/Commission.
Doctors practicing ethically and honestly should not How to Avoid Litigation?
have any reason for fear. Law whether civil, criminal a) Prevention at personal Level
or consumer law, can only set the outer limits of MCI approved qualification, training and experience
acceptable conduct i.e. minimum standards of of recognized center are the primary safeguard
professional care and skill, leaving the question of against any litigation.
ideal to the profession itself. Communication: This is the key to doctor Patient
The purpose of the Act: relationship. We should have polite and sympathetic
To protect the interest of the consumers of different attitude toward patients and their relatives.
commodities available to them for which they pay but Increasing crowds of patients and improper
do not get standard quality of service. e.g. patient communication to the patient about diagnostic and
pay for the treatment but do not get correct treatment procedures, complications and claims of
treatment. Any sufferer consumer, State / Central guaranteed success are the main reasons for
govt. may lodge the complaint against the erring Patient’s dissatisfaction. Answers all queries of the
trader or suppliers, etc for the deficient service which patients / relatives without getting irritated.
cause some harm to the consumer in the different Academic and Technical up gradations- One should
redressal forum. e.g. District Forum, State regularly attend Conferences, CMEs & Workshops to
Commission, National Commission. keep pace with progress in medical science. Other
Nature of Complaint: academic sessions should also be organized to up
Any unfair trade practice adopted by the trader, and grade our junior staff and nursing team.
defective goods, deficiency in services /Deficiency in Medical Ethics Laws: A thorough knowledge of
treatment, excess price charged by the trader /doctor medical ethics and laws is essential for all medical
by doing unnecessary investigation, prolonged professional. We should always get feed back from
hospital stay etc. for unlawful goods sale, which is our patients about our setup, our staff & charges etc.
hazardous to life and safety when used. A complaint Special training should be for doctors, paramedical
hand written or typed can be filed by a consumer. staff, nursing staff etc from HRD

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 JIAFM, 2007 29 (3); ISSN: 0971- 0973
experts about dealing with patients /relatives under Treatment by patient from other doctor / other
grievous mental stress due to some loss or injury. system of medicine simultaneously.
b) Prevention at Practice: More than one reason for occurrence of damage.
• Should have reasonable skill and care in Contributory Negligence.
diagnosis and treatment. Do’s and Don’ts for Doctors:
Do’s for Doctors:
• Proper documentation of facts and legally valid
• Mention your qualifications/ training/ experience/
informed Consent. The reasonable Skill and care.
designation on the prescription.
There are three aspects of reasonable skill and
care - Medical, Social & Legal • Always mention date and timing of the
Medical Aspect-First and foremost it is essential for consultation.
every Doctor /Hospital /Nursing home to exercise • Mention age and sex of the patient.
reasonable skill and care expected of an average
person with equivalent qualification and experience
• In a pediatric prescription weight of the patient
must also be mentioned.
in similar circumstances. Social Aspects-We should
always exhibit our reasonable skill and care to the • Always put your hand on the part that the patient/
patients / attendants / relatives through expression, attendant say is painful.
body language, action and discussion. We may be • Apply your stethoscope on him, even if for
very sincere toward patient but failure to exhibit these cosmetic reasons.
gestures may leads to doubts in the mind of patients
and their relatives. Legal aspects - This include
• Listen attentively. Look carefully, ask questions
intelligently.
proper documentation about exercising reasonable
skill and care in consultation, diagnosis and • Always face the patient. Do not stare, especially
treatment. This can be done by making good clinical female patients.
notes of finding on examination and treatment given. • Ask the patient to come back for review on the
When there is failure to follow instruction, refusal for next day, if you are not sure about the diagnosis/
investigation, failure to come for review on specified treatment.
day by patient, should always be recorded in • Mention “diagnosis under review” until the
underline way. These negative records act as diagnosis is finally settled.
important tool while defending our case in court of
law. • In complicated cases record precisely history of
Prevention by professional indemnity by insurance illness and substantial physical findings about the
cover -Professional indemnity insurance is a tool patient on your prescription.
which not only meets the claim of compensation • Record history of drug allergy.
awarded against the doctor /hospital but also gives
sense of mental security that even if same
• Write names of drugs clearly. Use correct
dosages.
negligence is proved the insurance company will take
care of it. Prevention by people support groups-By • Always advise the patient not to stop taking a
forming societies like I.M.A , Medical Collage drug suddenly which is required to be tapered
Teachers Welfare Society we get a type of social before it is stopped.
security. It also prohibit the doctor speaking foul
against there own colleague.
• Remember major drug interactions.
Factual defenses: • Mention if patient/ attendant are/ is under effect of
Mention qualification, training, experience etc. alcohol/ drugs.
We can say that complainant or patient has not • Adjust doses in case of a child/ elderly patient and
come to the court with clean hand i.e he has in renal or hepatic disorders.
suppressed material facts e.g. previous illness,
treatment etc. • In case of chronic ailments, mention treatment to
Written consent of the patients / relative / be taken immediately in case of an emergency.
attendant especially, involving special risk in the For example, a patient on anti-epileptic treatment
treatment. should be advised to take an injection of
Circumstances of the case e.g. there was diazepam when convulsions occur.
emergency, lack of facility (e.g. rural area) no • Mention where the patient should contact in case
one to give history of patients illness etc. Burden of your non-availability/ emergency.
of proof of duty of care, breach of that duty,
causation, damage etc, is on the patients or • If you are not sure what disease a patient has
complainants. after a thorough workup, get a consultation.
Reasonable knowledge, skill and care exercised. • Whenever referring a patient, provide him with a
referring note.

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 JIAFM, 2007 29 (3); ISSN: 0971- 0973
• In case of emergency/ serious illness, ring up the • Don’t give a drug parentally if it can be given orally.
concerned doctor in the patient’s presence in hospital There may be some exceptions.
casualty. • When you are not sure what and why to do. Consult
• Participate in at least one national / international your senior/ specialist/ colleague.
conference of respective subjects every year. • Don’t refuse the patient’s right to know about the
• Update your knowledge and skill from time to time. hospital rules, regulations and hospital charges.
• Update not only your own knowledge and skill, but • Don’t refuse if the patient/ attendants want to leave
also that of your staff. against medical advice (LAMA). It is their right.
• Update the facilities and equipment according to Document this properly.
prevailing current standards in your area. • Never avoid a call for help from a nurse on duty at
night. A genuine emergency may be there.
• Preferably employ qualified assistants. If not
available, impart proper training and skill at your or • Never label any condition as “functional” until you are
some appropriate centre and obtain a certificate for as certain as possible of the accuracy.
the same. • Don’t leave at the moment of death. There is a
• Routinely advice X-rays in injury to bones and joints tendency especially on the part of senior doctors to
and related diseases of bones/ joints. go away at this time when his presence and
experience are most needed.
• Always rule out pregnancy before subjecting the
• Don’t hesitate to extend your condolences and
uterus to X-ray.
sympathies to the bereaved persons.
• The period for the responsibility of the surgeon • Don’t issue death certificates unless you have
extends to and includes the post-operative care. yourself verified it.
• Always seek proper legal and medical advice before • Don’t divulge secrets you come to know during
filing reply to the complainant referred to you from a discharge of your professional duties.
consumer court.
Don'ts for Doctors:
• Don’t deny medical care to a patient with HIV
infection/ AIDS. Observe all necessary precautions.
• Don’t prescribe without examining the patient, even if
• Don’t inform that the person is infected with HIV
he is a close friend or relative.
unless confirmatory test results are received.
• Never examine a female patient without presence of
• Don’t give untrue, misleading or improper reports,
female nurse/ attendant, especially during genital and
documents, etc.
breast examinations.
• Don’t smoke while examining a patient.
• Do not leave a patient unattended during labor.

• Don’t examine a patient when you are sick,

Reference:
exhausted, or under influence of alcohol or any 1. Reddy K.S.N. Medical Laws and ethics. The Essentials of
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• Don’t be overconfident. Don’t look overconfident. 24th Edn. 2005. Pg-44-46
2. Nandy Apurba, Legal and Ethical Aspects of Practice of
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e.g. Analgin. Agency (P) Ltd., Calcutta, 2nd Edn Reprint 2005, Pg- 43-45
3. Rao Nagesh Kumar G., Ethics of Medical Practice. Textbook
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drug, too large a dose, for too long. Medical Publishers (P) Ltd. New Delhi, 1st Edn. Reprint 2006,
pg-64-68
• Don’t under-prescribe: dose is too small, length of 4. Ratanlal and Dhirajlal’s, offences Affecting Life. The Indian
treatment is too short. Penal code, Wadhwa and Company Law Publisher, New
Delhi , 28th Edn, Reprint 2001, Pg- 421-428
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professional enemy. The code of Criminal Procedure, Wadhwa and Company Law
Publisher, New Delhi, 15th Edn. Reprint 2002, Pg- 463-464
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polypharmacy. Textbook of Medical Jurisprudence, Forensic Medicine and
Toxicology, CBS Publishers and Distributers, 6th Edn, Reprint
• Don’t allow substitutions. 2006, pg- 1.42-1.44; 1.53; 12.20
• Don’t do anything beyond your level of competence. 7. Yadav Mukesh, Legal and Ethical Aspects of Casualty
Services in India, JIAFM , 2006, Vol. 28, Pg- 114-120.
• Competence is defined by your qualification, training
and experience.
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