Q). Short note on ACT OF GOD?

Ans). Medical Maloccurrence

1) Act of God
(i) Black’s Law Dictionary defines an act of God as “An act occasioned exclusively by
violence of nature without the interference of any human agency.” 
(ii) An act of god is an accident which is not reasonably foreseeable and is not
controllable. Any damage caused or any non-fulfilment directly because of Act of
God cannot create liability on the parties to a contract.
2) Act of God in Medicolegal parlance refers to Medical Maloccurrence, also called
as inevitable accidents. Medical maloccurrence is a legal term which defines a less
than ideal outcome that is unrelated to the quality of medical care delivered by
the health care team.
3) Medical Maloccurrence includes:
(i) Medical and surgical complications that can be anticipated, and represent
unavoidable risks of appropriate medical care.
(ii) Complications that arise unpredictably and are unavoidable.
(iii) Complications that arise as a result of decisions made by patient and doctor with
fully informed consent but appear, in retrospect, to have been a less appropriate
choice.
4) Causes behind medical maloccurrence –
(i) Human beings show biological variation which cannot always be
explained, expected or prepared for. It is often said that diversity in biology is a rule
rather than exception. Thus, an individual may show varying biological variation.
(ii) In some individuals, despite giving good medical care and skill, the patient may
suffer or does not respond properly to treatment.
(iii) Maloccurrence is often unrelated to the reasonable risks of quality of care that
was provided.

5) Examples –
(i) Idiosyncratic response to drugs in some patients
(ii) Damage to recurrent laryngeal nerve during thyroidectomy leading to vocal cord
paralysis.
(iii) Rupture of the posterior capsule is a well-known complication of cataract surgery.
(iv) Breaking of a needle during intramuscular injection due to sudden muscular
spasm.
(v) Amniotic fluid embolism following Cesarean section
6) Responsibility of doctor –
(i) There is good medical attention and care.
(ii) Inevitable accidents happen and not avoidable by any such precautions as a
reasonable man can be expected to take.
(iii) If the doctor had exercised reasonable degree of care and skill and in spite of
this the patient do not respond or medical maloccurrence develops; the doctor
would not be held responsible.
(7) Defence of doctor in court in medical negligence –

(i) While determining the liability in cases where the defendant pleads for the
defense of Act of God, the point of determination is whether the damage is directly or
indirectly caused by Act of God and whether there was any negligence on the part of
the defendant or whether the defendant failed to exercise reasonable precautions for
avoiding damages.

(ii) If damage caused involves some contribution of the negligence of the defendant,
he will be liable for his negligence.

(iii) Before an act of God is granted as a defense the defendant has to prove himself
to have done everything that a reasonable and a prudent person could do in such a
scenario.

(iv) As Medical maloccurrence happens on certain occasion, despite all proper care
given by the doctor. If the doctor can prove this before the court, it will be an
absolute defence against malpractice.