Levels of Medical Negligence in Clinical Cases

Law influences every aspect of human activities; healthcare is no exception. Lack of knowledge regarding medicolegal aspects halts the effective implementation and delivery of efficient services.

The term medicolegal refers to both medicine and law. The medicolegal term can be referred as two things:

  1. Study and application of medical & scientific methods as evidence in a legal case, for example, paternity, rape, etc. This is also known as legal medicine or medical jurisprudence.
  2. Medical law is a branch that governs medical practices.

Medicolegal issues are clinical cases that may result in litigation as a result of an act or omission (you are duty-bound to do any act and you could not do so), failure, carelessness, negligence, or inability of the clinician to discharge his professional obligations and duties. The medicolegal case involves any injury or medical condition in which law enforcement agencies investigate and fix the responsibility regarding the injury or medical condition.

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The medical profession has its own ethical parameters and code of conduct. Professional negligence is the absence of care and skill of a medical practitioner in the treatment of a patient which causes bodily injury or death to the patient. Negligence done by medical professionals is decided by the law who relies on expert opinion from the medical field.

There is a very thin line between medical negligence and medical error which is very well defined, explained, and settled by the Supreme Court. There are different levels of negligence that have a very thin line demarcation and the level of negligence also depends on various factors like the place, the time, the individuals involved, and the level of complications.

There are 3 levels of negligence, explained by Roman law:

  1. Lata culpa, is a Latin term which means gross neglect. Lata culpa is common or ordinary negligence or the absence of reasonable care. It is an absence of the degree of care that even an inattentive and thoughtless person would exercise in any circumstances. For example: Suppose a doctor has done some operation with all due care and attention but inspite of taking care of all the measures some small injury happened because of the omission and that is not affecting the patient in serious form, meaning the degree of injury is small.

  2. Levis culpa, is ordinary negligence arising from one’s failure to exercise such care in the interest of another as he exercises his own affairs. He who is answerable for levis culpa is answerable for injury caused to the property of another by some omission, which a careful person could have prevented.

  3. Levissima culpa, is slight neglect. It came within the meaning of the term culpa in the lex Aquilia; that is, an injury that happened to one man’s property through the conduct of another, for want of such care as the most careful person would take, was a culpa, and therefore punishable. The degree of harm in levissima culpa is higher than any other negligence.

In levissima culpa, the harm is caused by any other person and the person who are getting injured needs too much care and attention or diligence. For example, the Doctor is doing some operation with all his team members, and the operation is very risky, but somehow due to the reason of other staff things went wrong and the patient suffers a huge injury. Here the doctor is responsible because he needs to care for the patient during the operation with due diligence, as he knows the fact that the matter is too serious, so the doctor would be liable for negligence.

Doctors must be aware of the laws involved with the medical profession and also should know about the ethics involved with the medical profession. The doctor must inform the patient and caretaker about the seriousness, pros & cons of the treatment/operation before starting any line of procedure and must take the consent, preferably in the written form.


Dr Shilpa Subramanian

Dr. Aparna Mishra is a practicing dentist with over 11 years of experience. Her interests include writing especially literature writing.

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