Arseculeratne v. Priyani Soysa

Arseculeratne v. Priyani Soysa is a landmark and contro-versial case of alleged medical malpractice in Sri Lanka.Apart from being the first such case in recent times, it isalso unique because the principal parties to the case werewell known professionals of the country - lawyer RienzieArseculeratne (Plaintiff) and Emeritus Professor of Pae-diatrics, Priyani Soysa (Defendant).

1 Material facts

The plaintiff’s three-year-old daughter Suhani, was shownto the defendant with the complaint of dragging of feet.The defendant examined the child and observed involun-tary movements of the upper limbs based on which shemade a diagnosis of Rheumatic Chorea and admitted thechild to hospital for further management. As there was noimprovement in the child’s condition after several days ofhospital stay, the plaintiff discharged his daughter fromthe care of the defendant and entrusted her to ProfessorSanath Lamabathusooriya, Professor of Paediatrics of theFaculty of Medicine, University of Colombo.Prof. Lamabadusuriya initially concurred with the diag-nosis of Rheumatic Chorea, making an entry in the BedHead Ticket- “All features of Rheumatic Chorea Seen”.He however noted that, unlike in Rheumatic Chorea,the tendon reflexes were brisk. Two days later after re-examining the child, Prof. Lamabadusuriya ordered a CTscan of the brain, since he could not exclude the possibil-ity of a Space Occupying Lesion in the Brain.The CT Scan revealed a Brain Stem Glioma (BSG),which is a growth of certain nerve cells in the proximalpart of the brain which houses most of the vital struc-tures necessary for life - hence it is associated with a verypoor prognosis . The local neurosurgeons consulted wereunanimous in their opinion that the tumour was inopera-ble. The distressed parents thereafter took the child to theUnited Kingdom for review by Neurosurgeon Dr. SrilalDias, who also stated that no surgery was possible in thepresent state.The child died a few days after returning to Sri Lanka.

2 Legal issues

The plaintiff’s case was that the defendant was negligentin not diagnosing Brain Stem Glioma and in the misdiag-nosis of Rheumatic Chorea. Had a timely diagnosis been

made, it was argued by the plaintiff, survival or prolonga-tion of life would have been possible.Although the plaintiff listed several specialist doctors in-cluding Prof. Lamabadusuriya as witnesses, only Dr. Sri-lal Dias was called to give evidence. It was alleged by hiscounsel that doctors in the country were reluctant to tes-tify against the defendant in view of her esteemed stand-ing in the medical profession.Dr. Dias claimed that had the BSG been diagnosed ear-lier curative radiotherapy or surgery would have been pos-sible. His claim was disputed by all expert witnesses whotestified for the defendant, including the eminent neu-rosurgeon Dr. Shelton Cabraal. Since the tumour wasfound in the brain stem region it is extremely unlikely thatany form of treatment would have had prospect of cure.The defendant argued that since Prof. Lamabadusuriyatoo made an initial diagnosis of Rheumatic Chorea andordered a CT scan only two days later, she was not neg-ligent in her care. This argument was controversially re-jected by all courts including the Supreme Court, whichheld that the defendant was negligent in not ordering aCT Scan.Since Brain Stem Glioma was a terminal condition withno prospect of effective treatment, it was also argued forthe defendant that even if her negligence was established,causation had not been proved and as such the plaintiff’saction should fail. It was on this ground that the SupremeCourt allowed her appeal.

3 The trial

The case lasted almost a decade traversing the full extentof litigation in the country - from the District Court ofColombo to the Court of Appeal to finally the SupremeCourt. The District Court upheld the Plaintiff’s case andawarded him Rs. 5,000,000 (around US$ 125,000 at thetime) and costs.Arseculeratne was represented by eminent civil lawyerPresident’s Counsel Romesh de Silva throughout the pro-ceedings while Prof. Soysa was defended by Queen’sCounsel VernonWijetunga at the District Court, and laterby President’s Counsel H.L. de Silva and senior lawyerR.K.W. Goonesekere at the appellate courts.Prof. Soysa’s appeal to the Court of Appeal was dis-missed, however the quantum of damages was reducedas under the Common Law of Sri Lanka which is Ro-

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2 4 REFERENCES

man Dutch law, damages could only be awarded for pat-rimonial loss. The Supreme Court allowed Prof. Soysa’sappeal setting aside judgments of both lower courts. Ina landmark judgment heavily critical of the decisions ofthe lower courts, the Supreme Court held that causationwas not established on a balance of probabilities by theplaintiff. The defendant was also allowed costs of action,which she declined to accept.

4 References• Goonaratna Colvin. A Doctor’s Quest for Justice:Prof. Priyani Soysa Vs. Rienzie Arseculeratne. Vi-jitha Yapa Publishers. 2005

• Prof. Priyani Soysa Vs Rienzie Arseculeratne. SriLanka Law Reports Vol 2 of 2001 pages 293-332.

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5 Text and image sources, contributors, and licenses

5.1 Text• Arseculeratne v. Priyani Soysa Source: https://en.wikipedia.org/wiki/Arseculeratne_v._Priyani_Soysa?oldid=699593227 Contributors:Gene Nygaard, Apokrif, Vsion, Wavelength, Elonka, Nuradh, Schmloof, Yobot, Cossde, RevelationDirect, Johnsoniensis and Anonymous:6

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