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Q) Write a note on Novus actus interveniens?

A) (I) Definition - Novus actus interveniens [Syn - Nova Causa Interveniens, an unrelated act intervening] refers to a situation, where the doctor
has been negligent, but a completely unexpected and unforeseen act happened which further worsened the patient's condition. Doctor is not
liable for loss precipitated or aggravated by such an unforeseen and unexpected event.

(II) Salient features:

(1) A person is responsible not only for his actions, but also for the logical consequences of those actions. This principle applies to cases of
assault and accidental injury. Sometimes, such a continuity of events is broken by an entirely new and unexpected happening, due to
negligence of some other person.
(2) The new act intervening should be completely unexpected and unforeseen. Sometimes referred to as an "Act of God".
(3) There is breaking of the chain of causation between the act of negligence and the resulting damage.
(4) Thus injury no more remains an outcome as a result of doctor’s negligence as proximate cause.
(5) A doctor may not be held responsible if damage occurred to patient due to new action, which intervenes in the treatment.
(III) Novus actus interveniens may take three forms namely:-
(1) Mere natural event independent of any human agency – “Act of God”. Where the new act has occurred naturally independent of human
interference and was unforeseeable and unexpected. Ex – falling of ceiling fan over the patient, spread of dengue in hospital patients, etc.

(2) An act (or omission) by a third party - Where the new act is of a 3rd party, the test is whether the act was foreseeable. If the act was
foreseeable, the defendant doctor remains liable and the chain of causation remains intact. If the act of 3 rd party is not foreseeable this will
break the chain of causation and the defendant doctor is not liable for the actions of 3rd party.

(3) The conduct of the claimant (patient) himself – where the new intervening act is that of the patient party, the test is whether the patient party
acted reasonably in the circumstances. If the patient party’s actions are deemed reasonable the chain of causation remains intact and the
defendant doctor is liable for the actions of the patient party. If however the patient party’s actions are unreasonable in the circumstances the
chain of causation is broken and the defendant doctor is not liable for the actions of the patient party.

(IV) Example’s-
(1) An MI patient is under doctor’s care since long-> telephones doctor that he is having severe chest pain-> doctor does not take him seriously
and does not come to see him -> patient phones again and again -> doctor continues to ignore [negligence of doctor]-> After a few hours,
patient’s wife phones that her husband’s condition is worsening -> Doctor panics -> sends an ambulance -> instructs the driver to bring the
patient back as fast as possible -> As ambulance is coming back fast, it overturns -> kills the patient -> wife sues doctor. Analysis – Doctor is
indeed negligent, but death was not the proximate cause of negligence. It was overturning of ambulance, which was completely unexpected
and unforeseen. Plea of novus actus interveniens may succeed.
(2) Patient admitted to hospital treated with negligence -> Patient’s condition starts getting worse -> Dengue breaks out in the hospital ->
Patient dies of dengue -> Relative sues doctor. Plea of novus actus interveniens may succeed.

(V) The doctrine of Novus Actus Interveniens can be used as defence for doctor in cases of alleged medical negligence when an
unforeseeable and unexpected event occurs which worsens patients condition further breaking the chain of causation and medical negligence
is no more the proximate cause for patient’s injury or deteriorated condition.