Kerala High Court: The present petition was filed by the on-call Medical Officer (‘accused’) seeking quashment of criminal proceedings for medical negligence under Section 304-A of the Penal Code, 1860 (‘IPC’) in relation to the death of a remand prisoner. A Single Judge Bench of V.G. Arun, J., quashed the proceedings against the accused observing that a medical practitioner would only be liable under Section 304-A IPC if he would have committed a rash or negligent act that resulted in the patient’s death.
Background
A remand prisoner suffered multiple seizures on 11-01-2021 and 12-01-2021 and sustained head injuries after a fall. He was initially treated at local hospitals but due to lack of beds, he was referred to Government Medical College Hospital, Kottayam. Around 4:00 a.m. on 12-01-2021, after suffering another seizure, he was referred for neurosurgery consultation. The Senior Resident examined him and intimated the accused about his condition over the phone, who advised a CT-scan and pre-operative investigations to be prepared for emergency surgery.
On 13-01-2021, when the accused’s duty ended at 8:00 a.m., another doctor (co-accused) assumed charge as the on-call Medical Officer. Despite recommendations for emergency surgery following worsening scan results, the procedure was delayed due to unavailability of the operation theatre. The patient died at 03:25 p.m. the same day, while awaiting surgery. An FIR was registered and his death led to public protests alleging custodial torture, prompting a Crime Branch investigation. An Expert Panel, constituted to investigate complaints against the doctors later concluded that the patient had not received reasonable medical care while undergoing the treatment, resulting in criminal charges under Section 304-A IPC against the accused doctors.
The accused’s counsel contended that even if the prosecution allegations were accepted, the offence under Section 304-A IPC would not be attracted because the golden hour, as far as a person with seizure was concerned, was six hours and the inordinate delay in providing proper treatment and medication worsened the patient’s condition. By the time the accused was informed about the patient, 18 hours had elapsed after the first CT-scan. It was also the peak pandemic period, and the Government advisories prevented the accused from examining the patient physically. It was also submitted that, in the appeal filed by the accused against the Expert Panel Report, the State Level Apex Expert Committee held that there was no gross and culpable negligence by the doctors at the Medical College in giving treatment to the patient.
However, the Public Prosecutor submitted that the matter was still under investigation and the investigating officer was not bound by the Apex Body’s findings. Therefore, if sufficient materials were gathered to prove the accused’s complicity, he could be prosecuted for the alleged offence.
Analysis and Decision
The Court opined that while negligence was an omission to do something which a reasonable man, guided upon those considerations which ordinarily regulated the conduct of human affairs, would do, or the doing of something which a prudent and reasonable man would not do, medical negligence occurred when a healthcare professional breached his duty of care, causing harm to a patient.
The Court referred to Suresh Gupta (Dr.) v. Govt. of NCT of Delhi, (2004) 6 SCC 422, where the Supreme Court held that “for fixing criminal liability on a doctor or a surgeon, the standard of negligence required to be proved must be so high as can be described as ‘gross negligence’ or ‘recklessness’. It was not merely lack of necessary care, attention and skill”. Suresh Gupta (supra) was affirmed by the Supreme Court in Jacob Mathew v. State of Punjab, wherein it was observed that “a simple lack of care, an error of judgment or an accident, was not proof of negligence on the part of a medical professional. As long as a doctor followed a practice acceptable to the medical profession of that day, he could not be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resorted to that practice or procedure which the accused followed”.
The Court reiterated that a medical practitioner could be prosecuted for medical negligence only if the treatment adopted by him was contrary to the general and approved practice. Moreover, to attract the offence under Section 304-A, the doctor must have committed a rash or negligent act, and the death must also be the direct or proximate result of the rash or negligent act of the accused.
The Court noted that the accused directed a fresh CT-scan as soon as he was informed of the patient’s condition and after receiving the report advised immediate surgery. The accused could also not be attributed with gross negligence for his failure to examine the patient physically since the COVID restrictions prevented it. Further, the accused’s duty ended by 8:00 a.m., and the delay in conducting the surgery occurred due to the non-availability of the operation theatre.
The Court observed that the Expert Panel had only opined that the patient had not received a reasonable standard of care while under treatment in Government Medical College, Kottayam, without naming any particular doctor. Further, that opinion of the Expert Panel lost its relevance in view of the conclusive unanimous opinion of the State Level Apex Body that there was no gross and culpable negligence on the part of the treating doctors for giving treatment to the patient.
Consequently, the Court held that the prosecution of the accused for the offence under Section 304-A IPC amounted to an abuse of the process of the Court. The Court quashed all further proceedings against the accused relying on State of Haryana v. Bhajan Lal, 1992 Supp (1) SCC 335, wherein the Supreme Court had observed that an FIR was liable to be quashed when the allegations, even if accepted in their entirety, did not make out the ingredients for constituting the offence alleged against the accused.
[Vinu V. Gopal v. State of Kerala, 2025 SCC OnLine Ker 6093, decided on 29-07-2025]
Advocates who appeared in this case:
For the Petitioner: J. Vishnu, Anu Balakrishnan Nambiar, Advocates.
For the Respondents: Pushpalatha. M.K, Sr. PP.
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