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DEPARTMENT OF PUBLIC HEALTH DENTISTRY
NAVODAYA DENTAL COLLEGE
DR.SOMANATH REDDY K
CONSUMER PROTECTION ACT AND
THE DENTIST
1
CONTENT
ā€¢ CPA an overview
ā€¢ Common Allegations against dentist
ā€¢ How to prevent from being sued
2
Mahatma Gandhi
ā€œA consumer is most important visitor on our
premises. He is not dependent on us, we are on
him. He is not an interruption to our work; he is
purpose of it. We are not doing favour to a
consumer by giving him an opportunity. He is
doing us a favour by giving us an opportunity to
serve himā€
3
Introduction
4
ā€¢ Practice of medicine is as old as the existence of
the human race. Originally, the priest functioned
as a preacher, teacher, judge as well as a healer.
ā€¢ With the passage of time not only practice of
medicine graduated to become an independent
and noble profession, but also the doctorā€™s
relationship has slowly shifted from
ā€˜Next to God' to ā€˜a Friend, a Philosopher and a
Guide', to ā€˜a Respected Professional' and today,to a
ā€œService Providerā€
5
ā€¢ We witness today a fast pace of
commercialization and globalization in all
spheres of life and the medical profession is no
exception to these phenomena.
ā€¢ Some incidences cause suffering to the patients,
forcing the legislature and the public to think
twice about the credibility and authenticity of
treatment given to the patients.
6
ā€¢ Earlier too, doctors were covered by various laws,
(the Law of Torts, IPC etc.) but since the passing of
the Consumer Protection Act in 1986, litigations
against doctors is on the increase.
7
Consumer Protection Act
(COPRA) 1986
8
ā€¢ The United Nations by Consumer Protection
Resolution No 39/248, on April 9th, 1985, had
recommended to its member countries, a
legislation to protect consumers through an easy
and inexpensive method.
ā€¢ India adopted this suggestion and on 24th
December 1986, the Indian Government passed
the Consumer Protection Act which came into
force on 15th April 1987.
9
ā€¢ The Aim and Objective of this act is better
protection of the interest of consumer and for
settlement of consumer disputes.
ā€¢ This Act is universal, covering public, private
and cooperative sectors.
ā€¢ Provisions of this Act are in addition to and not
in derogation of any other law for the time
being in force and are compensatory in nature.
10
ā€¢ Under this Act, the word "Consumer" has been
defined separately for "goods" and "servicesā€
[clause (d) of section 2(1) of CPA 1986 ]
11
ā€¢ A highlight of the consumer movement came in 1962
when President John F. Kennedy presented his
Consumer Bill of Rights. He declared that every
consumer has the following rights:
1. The Right to be Informed
2. The Right to Safety
3. The Right to Choose
4. The Right to be Heard
12
ā€¢ In 1969, President Richard M. Nixon added the fifth
right to the list;
ā€¢ 5. The Right to a Remedy
13
In 1975, President Gerald R. Ford added the sixth
6. The Right to Consumer Education
14
ā€¢ In 1994, President William Jefferson ("Billā€œ) Clinton
added the seventh.
7. The Right to Service
15
CONSUMER REDRESSAL FORUMS
NATIONAL CONSUMER DISPUTES REDRESSAL
COMMISSION
STATE CONSUMER DISPUTES REDRESSAL
COMMISSION
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
16
National consumer
dispute redressal
commission
State consumer dispute
redressal commission
District consumer dispute
redressal forum
ļ±New Delhi
ļ±President
and five
members
ļ±More than 20
lakhs
compensation
ļ±32 SCDRC in
India
ļ±President and
2 members
ļ±5 to 20 lakhs
compensation
ļ±569 DCDRF in
India
ļ±President and
2 members
ļ±Up to 5 lakhs
compensation
Three tier grievance redressal mechanism
ā€¢ The maximum time limit for a claim is 2 years
from the date of occurrence of the cause of
action.
ā€¢ A complaint filed will be decided within a period
of 90 days from the date of notice received by
opposite party(dentist) and within 150 days if it
requires analysis or testing of commodities.
18
Procedure on receipt of Complaint
ā€¢ Refer a copy of such complaint to the dentist,
directing him to give his version of the case
within a period of 30 days.
ā€¢ Where the dentist denies or disputes the
allegations contained in the complaint, or
omits or fails to take any action to represent
his case within the given time, the Forum
shall proceed to settle the consumer dispute.
19
FRIVOLOUS / VEXATIOUS
COMPLAINT
ā€¢ If the complaint found to be frivolous or
vexatious, forum dismiss the complaint and make
an order that the complainant(patient) shall pay to
the opposite party such cost, not exceeding ten
thousand rupees, as may be specified by the order.
20
PENALTIES
21
IMPRISONMENT
FINE
NOT < ONE MONTH,
MAY EXTEND UPTO 3
YEARS
NOT < 2000/-, MAY
EXTEND UPTO 10,000/-
CPA AND MEDICAL/DENTAL PROFESSION
ā€¢ Previously medical professionals debated that
medical services are of personal nature (contract
of personal services) so these should not be
included in this act.
ā€¢ But the Supreme Court of India on 13th Nov. 1995
declared that services provided by medical
profession is of ā€œcontract for serviceā€ not the
ā€œcontract of servicesā€. Thus these are included
under the Act.
ā€¢ 22
(Landmark case of Indian Medical Association vs. V.P.
Shantha) )
23
A patient
who PAYS to
get services
of doctor /
hospital
Any person
who PAYS FOR
the patient
Legal
representatives
of patient
Who is a CONSUMER ?
What does Deficiency in service means ?
ā€¢ Fault, imperfection, shortcoming or inadequacy
in quality, nature and manner of performance of
the medical/dental service rendered by a hospital
or doctors.
24
25
All Hospital/ Health
Centre/
Dispensary- free to
all patients
Emergency care
Practitioners
All Hospital/Health
Centre/Dispensary-
both charged as
well as free
If the Employer
bears the expenses
of medical/dental
treatment of an
Employee and his
family members,
NO
YES
WHO comes underCPA??
YES
Medical journal armed forces India 2007;63:172-3
26
ā€¢ The Consumer Protection Act will not come to the
rescue of patients if the service is rendered free of charge,
ā€¢ However, if patients' charges are waived because of
their incapacity to pay, they are considered to be
consumers.
WHO IS LIABLE?
ā€¢ Hospital authorities are liable- for doctors,
nurses and other hospital staff.
ā€¢ It is irrespective of whether their employment is
permanent or temporary, paid or honorary,
whole or part-time. (consultants).
27
RELIEF PROVIDED BY THE FORUM
ā€¢ To return to the complainant, the charges paid.
ā€¢ Pay the amount as may be awarded as compensation
to the consumer.
ā€¢ To remove the deficiency in the services in question.
ā€¢ To provide for adequate costs to parties.
28
PENALTY
ā€¢ 1 to 3 years imprisonment
with fine not < than 20,000
common allegations against dental professionals
29
allegations
ā€¢ Unnecessarily Prolonged treatment period.
ā€¢ Incomplete/ improper diagnosis.
ā€¢ Failure of obtaining relevant medical history.
ā€¢ Charging excess fee (not explained properly
before treatment).
30
ā€¢ Nosocomial Infections.
ā€¢ Iatrogenic injuries.
ā€¢ Broken needles.
31
allegations
ā€¢ Root left in socket without knowledge of the
patient.
ā€¢ Detached fragments entering the respiratory
passages.
ā€¢ Ill fitting appliances/dentures and faulty
restorations.
ā€¢ Complications arising from negligently completed
ā€¢ crowns and bridges.
32
allegations
ā€¢ Fracture and dislocation of jaw occurring during
dental procedures.
ā€¢ Nerve injuries that affected a patientā€™s ability to
taste or permanent numbness in tongue.
ā€¢ Extraction of wrong tooth
ā€¢ Death due to negligence.
33
allegations
how to prevent ourselves frombeing sued?
34
COMMUNICATION
ā€¢ Good communication and good relationship
ā€¢ Always listen to your patient.
ā€¢ Monitor the staff working under you, in their
interpersonal relationship with patients.
35
CONSENT
Informed consent is a legal condition whereby a
person can be said to have given consent based upon
a clear appreciation and understanding of the facts,
implications and future consequences of an action.
ā€¢ In language patient understands and patient must be
given an opportunity to clarify any doubts.
36
Consent is Not Valid when given under-
ā€¢Fear, fraud or misrepresentation of facts,
mentally challenged or who is under 12 years of
age.
(Sections 90 of the Indian Penal Code, 1860)
But CPA comes under contract act patient above
age 18 can give consent
37
EXAMINATION AND TREATMENT OF
PATIENT
ā€¢ Detailed Medical and Dental history.
ā€¢ Thorough clinical examination and radiographic
review.
ā€¢ Patientā€™s health history should be updated regularly.
38
ā€¢ Dentist should present both recommended
treatment plan and an alternative treatment plan.
ā€¢ Patient must be informed about the consequences
of refusal of treatment suggested by doctor.
(Informed refusal )
ā€¢ If patient is not informed ,doctor may be held
liable for any consequences occurred due to
refusal of patient.
39
ā€¢ Never guarantee the result of the treatment.
ā€¢ Never lie to patient about their treatment and
always keep them informed about their health
status.
40
ā€¢ Do not adopt experimental method in treatment. If
there is some rationale, do it only after informed
consent.
ā€¢ Use of unnecessary physical restraints in treatment
of uncooperative child should be avoided and if
necessary discuss this with the parents and have
them present in the operatory.
41
Records should include-
ā€¢ Consultation report, treatment record along with
Radiographs, Casts, Reports of lab tests.
ā€¢ Record of charges and payments.
ā€¢ An appointment book/log - appointment for
consultation/treatment, late arrivals, cancelled
appointments.
42
PATIENTā€™S RECORDS
Record ownership ā€“
ā€¢ Doctor is considered the custodian of the record
and the patient has a property right in its content.
ā€¢ On patientā€™s request for their records, comply but
supply only copies, and if you believe a patient
intends to sue, before you comply contact your
insurance carrier for advice.
43
PRESCRIPTION
ā€¢ Mention your qualifications on the prescription.
ā€¢ Always mention date and timing of the
consultation.
44
ā€¢ Write name of drugs clearly and mention
clearly method and interval of administration.
ā€¢ Mention additional precautions e.g., food ,
avoidance of certain drugs, alcohol, smoking etc.
if indicated.
45
ā€¢ If the patients/attendants are erring on any
account (refusing investigations, refusing
admission ) make a note of it or seek written
refusal preferably in local language with
proper witness.
46
PROFESSIONAL INDEMNITY
INSURANCE
ā€¢ This is designed to provide the insured
person protection against the financial
consequences of legal liability.
ā€¢ This policy will indemnify the person,
subject to the terms, conditions and
limitations of the contract.
47
48
Thank You

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Dentist Guide CPA Claims

  • 1. DEPARTMENT OF PUBLIC HEALTH DENTISTRY NAVODAYA DENTAL COLLEGE DR.SOMANATH REDDY K CONSUMER PROTECTION ACT AND THE DENTIST 1
  • 2. CONTENT ā€¢ CPA an overview ā€¢ Common Allegations against dentist ā€¢ How to prevent from being sued 2
  • 3. Mahatma Gandhi ā€œA consumer is most important visitor on our premises. He is not dependent on us, we are on him. He is not an interruption to our work; he is purpose of it. We are not doing favour to a consumer by giving him an opportunity. He is doing us a favour by giving us an opportunity to serve himā€ 3
  • 5. ā€¢ Practice of medicine is as old as the existence of the human race. Originally, the priest functioned as a preacher, teacher, judge as well as a healer. ā€¢ With the passage of time not only practice of medicine graduated to become an independent and noble profession, but also the doctorā€™s relationship has slowly shifted from ā€˜Next to God' to ā€˜a Friend, a Philosopher and a Guide', to ā€˜a Respected Professional' and today,to a ā€œService Providerā€ 5
  • 6. ā€¢ We witness today a fast pace of commercialization and globalization in all spheres of life and the medical profession is no exception to these phenomena. ā€¢ Some incidences cause suffering to the patients, forcing the legislature and the public to think twice about the credibility and authenticity of treatment given to the patients. 6
  • 7. ā€¢ Earlier too, doctors were covered by various laws, (the Law of Torts, IPC etc.) but since the passing of the Consumer Protection Act in 1986, litigations against doctors is on the increase. 7
  • 9. ā€¢ The United Nations by Consumer Protection Resolution No 39/248, on April 9th, 1985, had recommended to its member countries, a legislation to protect consumers through an easy and inexpensive method. ā€¢ India adopted this suggestion and on 24th December 1986, the Indian Government passed the Consumer Protection Act which came into force on 15th April 1987. 9
  • 10. ā€¢ The Aim and Objective of this act is better protection of the interest of consumer and for settlement of consumer disputes. ā€¢ This Act is universal, covering public, private and cooperative sectors. ā€¢ Provisions of this Act are in addition to and not in derogation of any other law for the time being in force and are compensatory in nature. 10
  • 11. ā€¢ Under this Act, the word "Consumer" has been defined separately for "goods" and "servicesā€ [clause (d) of section 2(1) of CPA 1986 ] 11
  • 12. ā€¢ A highlight of the consumer movement came in 1962 when President John F. Kennedy presented his Consumer Bill of Rights. He declared that every consumer has the following rights: 1. The Right to be Informed 2. The Right to Safety 3. The Right to Choose 4. The Right to be Heard 12
  • 13. ā€¢ In 1969, President Richard M. Nixon added the fifth right to the list; ā€¢ 5. The Right to a Remedy 13
  • 14. In 1975, President Gerald R. Ford added the sixth 6. The Right to Consumer Education 14
  • 15. ā€¢ In 1994, President William Jefferson ("Billā€œ) Clinton added the seventh. 7. The Right to Service 15
  • 16. CONSUMER REDRESSAL FORUMS NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION STATE CONSUMER DISPUTES REDRESSAL COMMISSION DISTRICT CONSUMER DISPUTES REDRESSAL FORUM 16
  • 17. National consumer dispute redressal commission State consumer dispute redressal commission District consumer dispute redressal forum ļ±New Delhi ļ±President and five members ļ±More than 20 lakhs compensation ļ±32 SCDRC in India ļ±President and 2 members ļ±5 to 20 lakhs compensation ļ±569 DCDRF in India ļ±President and 2 members ļ±Up to 5 lakhs compensation Three tier grievance redressal mechanism
  • 18. ā€¢ The maximum time limit for a claim is 2 years from the date of occurrence of the cause of action. ā€¢ A complaint filed will be decided within a period of 90 days from the date of notice received by opposite party(dentist) and within 150 days if it requires analysis or testing of commodities. 18
  • 19. Procedure on receipt of Complaint ā€¢ Refer a copy of such complaint to the dentist, directing him to give his version of the case within a period of 30 days. ā€¢ Where the dentist denies or disputes the allegations contained in the complaint, or omits or fails to take any action to represent his case within the given time, the Forum shall proceed to settle the consumer dispute. 19
  • 20. FRIVOLOUS / VEXATIOUS COMPLAINT ā€¢ If the complaint found to be frivolous or vexatious, forum dismiss the complaint and make an order that the complainant(patient) shall pay to the opposite party such cost, not exceeding ten thousand rupees, as may be specified by the order. 20
  • 21. PENALTIES 21 IMPRISONMENT FINE NOT < ONE MONTH, MAY EXTEND UPTO 3 YEARS NOT < 2000/-, MAY EXTEND UPTO 10,000/-
  • 22. CPA AND MEDICAL/DENTAL PROFESSION ā€¢ Previously medical professionals debated that medical services are of personal nature (contract of personal services) so these should not be included in this act. ā€¢ But the Supreme Court of India on 13th Nov. 1995 declared that services provided by medical profession is of ā€œcontract for serviceā€ not the ā€œcontract of servicesā€. Thus these are included under the Act. ā€¢ 22 (Landmark case of Indian Medical Association vs. V.P. Shantha) )
  • 23. 23 A patient who PAYS to get services of doctor / hospital Any person who PAYS FOR the patient Legal representatives of patient Who is a CONSUMER ?
  • 24. What does Deficiency in service means ? ā€¢ Fault, imperfection, shortcoming or inadequacy in quality, nature and manner of performance of the medical/dental service rendered by a hospital or doctors. 24
  • 25. 25 All Hospital/ Health Centre/ Dispensary- free to all patients Emergency care Practitioners All Hospital/Health Centre/Dispensary- both charged as well as free If the Employer bears the expenses of medical/dental treatment of an Employee and his family members, NO YES WHO comes underCPA?? YES Medical journal armed forces India 2007;63:172-3
  • 26. 26 ā€¢ The Consumer Protection Act will not come to the rescue of patients if the service is rendered free of charge, ā€¢ However, if patients' charges are waived because of their incapacity to pay, they are considered to be consumers.
  • 27. WHO IS LIABLE? ā€¢ Hospital authorities are liable- for doctors, nurses and other hospital staff. ā€¢ It is irrespective of whether their employment is permanent or temporary, paid or honorary, whole or part-time. (consultants). 27
  • 28. RELIEF PROVIDED BY THE FORUM ā€¢ To return to the complainant, the charges paid. ā€¢ Pay the amount as may be awarded as compensation to the consumer. ā€¢ To remove the deficiency in the services in question. ā€¢ To provide for adequate costs to parties. 28 PENALTY ā€¢ 1 to 3 years imprisonment with fine not < than 20,000
  • 29. common allegations against dental professionals 29
  • 30. allegations ā€¢ Unnecessarily Prolonged treatment period. ā€¢ Incomplete/ improper diagnosis. ā€¢ Failure of obtaining relevant medical history. ā€¢ Charging excess fee (not explained properly before treatment). 30
  • 31. ā€¢ Nosocomial Infections. ā€¢ Iatrogenic injuries. ā€¢ Broken needles. 31 allegations
  • 32. ā€¢ Root left in socket without knowledge of the patient. ā€¢ Detached fragments entering the respiratory passages. ā€¢ Ill fitting appliances/dentures and faulty restorations. ā€¢ Complications arising from negligently completed ā€¢ crowns and bridges. 32 allegations
  • 33. ā€¢ Fracture and dislocation of jaw occurring during dental procedures. ā€¢ Nerve injuries that affected a patientā€™s ability to taste or permanent numbness in tongue. ā€¢ Extraction of wrong tooth ā€¢ Death due to negligence. 33 allegations
  • 34. how to prevent ourselves frombeing sued? 34
  • 35. COMMUNICATION ā€¢ Good communication and good relationship ā€¢ Always listen to your patient. ā€¢ Monitor the staff working under you, in their interpersonal relationship with patients. 35
  • 36. CONSENT Informed consent is a legal condition whereby a person can be said to have given consent based upon a clear appreciation and understanding of the facts, implications and future consequences of an action. ā€¢ In language patient understands and patient must be given an opportunity to clarify any doubts. 36
  • 37. Consent is Not Valid when given under- ā€¢Fear, fraud or misrepresentation of facts, mentally challenged or who is under 12 years of age. (Sections 90 of the Indian Penal Code, 1860) But CPA comes under contract act patient above age 18 can give consent 37
  • 38. EXAMINATION AND TREATMENT OF PATIENT ā€¢ Detailed Medical and Dental history. ā€¢ Thorough clinical examination and radiographic review. ā€¢ Patientā€™s health history should be updated regularly. 38
  • 39. ā€¢ Dentist should present both recommended treatment plan and an alternative treatment plan. ā€¢ Patient must be informed about the consequences of refusal of treatment suggested by doctor. (Informed refusal ) ā€¢ If patient is not informed ,doctor may be held liable for any consequences occurred due to refusal of patient. 39
  • 40. ā€¢ Never guarantee the result of the treatment. ā€¢ Never lie to patient about their treatment and always keep them informed about their health status. 40
  • 41. ā€¢ Do not adopt experimental method in treatment. If there is some rationale, do it only after informed consent. ā€¢ Use of unnecessary physical restraints in treatment of uncooperative child should be avoided and if necessary discuss this with the parents and have them present in the operatory. 41
  • 42. Records should include- ā€¢ Consultation report, treatment record along with Radiographs, Casts, Reports of lab tests. ā€¢ Record of charges and payments. ā€¢ An appointment book/log - appointment for consultation/treatment, late arrivals, cancelled appointments. 42 PATIENTā€™S RECORDS
  • 43. Record ownership ā€“ ā€¢ Doctor is considered the custodian of the record and the patient has a property right in its content. ā€¢ On patientā€™s request for their records, comply but supply only copies, and if you believe a patient intends to sue, before you comply contact your insurance carrier for advice. 43
  • 44. PRESCRIPTION ā€¢ Mention your qualifications on the prescription. ā€¢ Always mention date and timing of the consultation. 44
  • 45. ā€¢ Write name of drugs clearly and mention clearly method and interval of administration. ā€¢ Mention additional precautions e.g., food , avoidance of certain drugs, alcohol, smoking etc. if indicated. 45
  • 46. ā€¢ If the patients/attendants are erring on any account (refusing investigations, refusing admission ) make a note of it or seek written refusal preferably in local language with proper witness. 46
  • 47. PROFESSIONAL INDEMNITY INSURANCE ā€¢ This is designed to provide the insured person protection against the financial consequences of legal liability. ā€¢ This policy will indemnify the person, subject to the terms, conditions and limitations of the contract. 47