Arseculeratne v.

Priyani Soysa
Arseculeratne v. Priyani Soysa is a landmark and controversial case of alleged medical malpractice in Sri Lanka.
Apart from being the rst such case in recent times, it is
also unique because the principal parties to the case were
well known professionals of the country - lawyer Rienzie
Arseculeratne (Plainti) and Emeritus Professor of Paediatrics, Priyani Soysa (Defendant).

made, it was argued by the plainti, survival or prolongation of life would have been possible.

Dr. Dias claimed that had the BSG been diagnosed earlier curative radiotherapy or surgery would have been possible. His claim was disputed by all expert witnesses who
testied for the defendant, including the eminent neurosurgeon Dr. Shelton Cabraal. Since the tumour was
found in the brain stem region it is extremely unlikely that
any form of treatment would have had prospect of cure.

Although the plainti listed several specialist doctors including Prof. Lamabadusuriya as witnesses, only Dr. Srilal Dias was called to give evidence. It was alleged by his
counsel that doctors in the country were reluctant to testify against the defendant in view of her esteemed standing in the medical profession.

Material facts

The plaintis three-year-old daughter Suhani, was shown

to the defendant with the complaint of dragging of feet.
The defendant examined the child and observed involuntary movements of the upper limbs based on which she
made a diagnosis of Rheumatic Chorea and admitted the
child to hospital for further management. As there was no
improvement in the childs condition after several days of
hospital stay, the plainti discharged his daughter from
the care of the defendant and entrusted her to Professor
Sanath Lamabathusooriya, Professor of Paediatrics of the
Faculty of Medicine, University of Colombo.

The defendant argued that since Prof. Lamabadusuriya

too made an initial diagnosis of Rheumatic Chorea and
ordered a CT scan only two days later, she was not negligent in her care. This argument was controversially rejected by all courts including the Supreme Court, which
held that the defendant was negligent in not ordering a
CT Scan.

Prof. Lamabadusuriya initially concurred with the diagnosis of Rheumatic Chorea, making an entry in the Bed
Head Ticket- All features of Rheumatic Chorea Seen.
He however noted that, unlike in Rheumatic Chorea,
the tendon reexes were brisk. Two days later after reexamining the child, Prof. Lamabadusuriya ordered a CT
scan of the brain, since he could not exclude the possibility of a Space Occupying Lesion in the Brain.

Since Brain Stem Glioma was a terminal condition with

no prospect of eective treatment, it was also argued for
the defendant that even if her negligence was established,
causation had not been proved and as such the plaintis
action should fail. It was on this ground that the Supreme
Court allowed her appeal.

The CT Scan revealed a Brain Stem Glioma (BSG),

which is a growth of certain nerve cells in the proximal
part of the brain which houses most of the vital structures necessary for life - hence it is associated with a very
poor prognosis . The local neurosurgeons consulted were
unanimous in their opinion that the tumour was inoperable. The distressed parents thereafter took the child to the
United Kingdom for review by Neurosurgeon Dr. Srilal
Dias, who also stated that no surgery was possible in the
present state.

3 The trial
The case lasted almost a decade traversing the full extent
of litigation in the country - from the District Court of
Colombo to the Court of Appeal to nally the Supreme
Court. The District Court upheld the Plaintis case and
awarded him Rs. 5,000,000 (around US$ 125,000 at the
time) and costs.
Arseculeratne was represented by eminent civil lawyer
Presidents Counsel Romesh de Silva throughout the proceedings while Prof. Soysa was defended by Queens
Counsel Vernon Wijetunga at the District Court, and later
by Presidents Counsel H.L. de Silva and senior lawyer
R.K.W. Goonesekere at the appellate courts.

The child died a few days after returning to Sri Lanka.

Legal issues

The plaintis case was that the defendant was negligent Prof. Soysas appeal to the Court of Appeal was disin not diagnosing Brain Stem Glioma and in the misdiag- missed, however the quantum of damages was reduced
nosis of Rheumatic Chorea. Had a timely diagnosis been as under the Common Law of Sri Lanka which is Ro1

man Dutch law, damages could only be awarded for patrimonial loss. The Supreme Court allowed Prof. Soysas
appeal setting aside judgments of both lower courts. In
a landmark judgment heavily critical of the decisions of
the lower courts, the Supreme Court held that causation
was not established on a balance of probabilities by the
plainti. The defendant was also allowed costs of action,
which she declined to accept.

References
Goonaratna Colvin. A Doctors Quest for Justice:
Prof. Priyani Soysa Vs. Rienzie Arseculeratne. Vijitha Yapa Publishers. 2005
Prof. Priyani Soysa Vs Rienzie Arseculeratne. Sri
Lanka Law Reports Vol 2 of 2001 pages 293-332.

REFERENCES

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Arseculeratne v. Priyani Soysa Source: https://en.wikipedia.org/wiki/Arseculeratne_v._Priyani_Soysa?oldid=699593227 Contributors:

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