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1976 Supreme(Bom) 39

IN THE HIGH COURT OF BOMBAY
V.S. Deshpande P.S. Shah, JJ.
Kusum David Kharat.... Appellant.
Versus
State of Maharashtra another.... Respondents.
Criminal Appeal No. 542/1972 with Criminal Appeal Nos. 673 1051/1972 with Criminal Revision Application Nos. 673 674/1972 with Criminal Application No. 430/1972, decided on 10-2-1976.
Advocates appeared :
S.B. Kotwal, M.J. Gordhandas V.S. Kotwal, for appellant-accused No. 2.
K.H. Nagrani with T.C. Motwani and S.B. Keswani, for complainant.
Vlias V. Kamat, for State.
In Criminal Appeal No. 542 of 1972.
Vilas V. Kamat, Public Prosecutor for State.
K.H. Nagrani with S.B. Keswani, for complainant.
S.B. Kotwal with S.R. Chitnis, for accused No. 1.
In Criminal Appeal No. 673 of 1972 (By State).
K.H. Nagrani, T.C. Motwani, S.B. Keswani, for applicant-original complainant.
S.B. Kotwal with V.S. Kotwal, for respondent No. 1.
Vilas V. Kamat, for State.
In Criminal Appeal No. 1051 of 1972.
K.H. Nagrani, T.C. Motwani and S.B. Keswani, for applicant-original complainant.
K.M. Desai with N.K. Thakore, for respondent No. 1.
Vilas V. Kamat, for respondent No. 2 (State).
In Criminal Revision Application No. 673 of 1972.
K.H. Nagrani T.C. Motwani and S.B. Keswani, for applicant/original complainant.
J.G. Pradhan, for respondent No. 1.
Vilas V. Kamat, for State.
In Criminal Revision Application No. 674 of 1972.
K.H. Nagrani with T.C. Chaproo, Advocate for applicant/original complainant.
V.V. Kamat, Public Prosecutor for State, in Criminal Application No. 430 of 1972.

Important Points

In a case of medical negligence, the prosecution must prove that the accused were negligent and that the death of the deceased was the direct result of such negligence.

Subject

Criminal Law - MEDICAL NEGLIGENCE

Act Referred

CRIMINAL PROCEDURE CODE : S.476, S.479(a)
INDIAN PENAL CODE : S.304(a)

Headnote

MEDICAL NEGLIGENCE - INFUSION OF GLUCOSE - CAUSATION OF DEATH - EVIDENCE - STANDARD OF CARE - BURDEN OF PROOF - SECTION 304-A IPC - CRIMINAL APPEAL - ACQUITTAL - CONVICTION - SECTION 479-A CRPC - SECTION 476 CRPC - CRIMINAL REVISION - LEGALITY AND VALIDITY OF ORDERS - DISCHARGE OF NOTICES.

Fact of the Case:

The deceased, P.S. Maker, was admitted to Bhatia General Hospital on the evening of 26th August, 1969, for administering two Glucose bottles on the advice of his family doctor, Dr. Dalal. The infusion of Glucose seems to have had adverse reactions, contrary to the expectation. The deceased died on 30th in the Hospital, cause of death shown in the records being Infective Hepatitis and Hepatico Renal failure.

Finding of the Court:

1. The accused, Dr. Mukhatiar (D. W. 4) and Dr. Gokhale (D.W.5) had given false evidence deliberately and had directed notices to be issued to them under section 479-A of the Criminal Procedure Code to show cause why they should not be tried for offence of perjury. After the written statements were submitted by these two witnessess, the learned Magistrate discharged the said notices by his order dated 20th June, 1972. 2. The trial Magistrate also had called upon accused No.1 under section 476, Criminal Procedure Code, to show cause why he should not be tired for an offence of fabrication of records. The trial Magistrate ultimately discharged the said notice also.

Issues: 1. Whether the accused or anyone of them were culpably negligent in treating the deceased patient Maker? 2. Whether the death of the deceased was the direct result of any such culpable negligence?

Ratio Decidendi: 1. The prosecution failed to prove that the accused were negligent in infusing Glucose to the deceased. 2. The prosecution failed to prove that the death of the deceased was the direct result of any culpable negligence on the part of the accused.

Final Decision: 1. The conviction of accused No. 2 is set aside. 2. The acquittal of accused No. 1 is upheld. 3. The orders of the learned Additional Chief Presidency Magistrate discharging notices against D. W. 4 Dr. Mukhatiar and D. W. 5 Dr. Gokhale are upheld.

JUDGMENT - V.S. DESHPANDE, J.:---One P.S. Maker was admitted at Bhatia General Hospital on the evening of 26th August, 1969, for administering two Glucose bottles on the advice of his family doctor, Dr. Dalal. Arrangements for his admission in the Hospital were made by Dr. Dalal directly through the House Surgeon, accused No. 1, Dr. Dalal himself being Honorary Surgeon of the Hospital. He was admitted in Special Room No. 115-A as Class II patient. His wife, the complainant, and his son Anil accompanied him. Unfortunately, this infusion of Glucose seems to have had adverse reactions, contrary to the expectation. There is controversy whether proper precautions were taken before the infusion and whether immediate steps were taken to stop the infusion and the reaction and whether any senior doctor actually was called and whether the Complainant objected to his treatment and if patient entered into coma at 2.00 a.m. that night. It is, therefore, common ground that rigours stopped after two injections and subsequent fever also subsided and from 11.00 a.m. on 27-8-1969 good treatment was given and there was short lived improvement. Maker, however, died on 30th in the Hospital, cause of death shown in the records being Infective Hepatitis and Hepatico Renal failure.

2. After about five weeks, on or about 9th October, 1969, a complaint by post, signed by the Complainant on 7th, was received by the Chief Presidency Magistrate (hereinafter referred to as C. P. M.) alleging negligence against the House Surgeon, accused No. 1, the nurse, accused No. 2, and Dr. Dalal. The learned C.P.M. called for a report from the police. Case papers and records from the Hospital seem to have been seized and concerned Doctors and other witnesses seem to have been examined in the course of this investigation. "No offence" report was submitted by the police. The learned C.P.M., however, issued process against the two accused. In due course, a charge was framed against both the accused on 25th March, 1971, for an offence under section 304-A I.P.C. It is first alleged that the Glucose saline was intravenously administered without taking the precaution of suppressing his immune sensitivity, though the patient, Maker, was suffering from jaundice, giving rise to anaphylactic shock. As accused No. 2 is alone alleged to have processed this infusion, this part of the charge is mainly directed against her, accused No. 1s alleged negligence being in allowing the nurse, accused No. 2, to do it herself. It is, secondly, alleged that no adequate and immediate treatment was given for the said shock to arrest the deterioration during the reversible pre-coma period on the night of 26th and 27th August, 1969. This part of the charge is obviously directed mainly against accused No. 1, the doctor.

3. In support of her case, the complainant examined herself, her son Anil and one Dr. Karamchandani, as Medical Expert. Other evidence consists of five formal witnesses examined either to produce the hospital record or prove the bills for medicine and hospital expenditure, about which there is little controversy.

4. The accused denied that they were negligent either in infusion of the Glucose or subsequent treatment. They also denied that the death of the patient was caused by anything done or omitted to be done by either of them. Accused No. 2 denied that accused No. 1 was not present at the time the patient was examined and infusion commenced. Accused No. 1 asserts that he was present from the beginning and at the time of infusion.

5. On behalf of the defence, five witnesses were examined. D.W.I. Dashrath Narayan produced Male Ward II, Day and Night Report Book and Special Order Book Y and Y-2, as also laboratory finding register at Exhibit 6, Bio-chemical findings register at Exhibit 7, Laboratory despatch book at Exhibit 8 and Night Sisters Report Book at Exhibit 9. D.W. 2 Dr. Sathe has been examined to prove the condition of the patient, when the patient was examined on 27th mor




























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