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Supreme Court of India
R.C. Lahoti, C.J.I.; G.P. Mathur & P.K. Balasubramanyan, JJ.
Jacob Mathew (DR.)—Appellant
versus
State of Punjab & Anr.—Respondents
Criminal Appeal No. 144-145 of 2004 from Judgment and Order dated 18.12.2002 and 24.1.2003 of Punjab and Haryana High Court in Crl. Misc. No. 21940-M of 1999 and Crl. Misc. No. 1984 of 2003—Decided on 5.8.2005

Counsel for the appearing Parties :
Mr. G.E. Vahanvati, Solicitor General, Mr. Rakesh Dwivedi, Mr. Ashok H. Desai, Mr. Vivek K. Tankha, Senior Advocates with Mr. Rupinder Singh Suri, Mrs. Gurvinder Suri, Mr. Jagjit Singh Chhabra, Mr. Atul Nanda, Additional Advocate General for State of Punjab, Mr. Bimal Roy Jad, Mr. P.N. Puri, Mr. Maninder Singh, Mr. Kirtiman Singh, Mr. Saurabh Mishra, Mr. Angad Mirdha, Mrs. Pratibha M. Singh, Mr. Devadatt Kamat, Ms. Rameeza Hakem, Mr. Chinmoy Pradip Sharma, Mr. Hrishikesh Barua, Ms. Suruchi Suri, Mr. Ravinder Narain, Ms. Sushma Sharma, Ms. Meghalee Barthakur, Ms. Kanika Gamber, Mr. Rajan Narain, Mr. Harekhrishna Upadhyaya, Mr. Prashant Kumar, Mr. Siddhartha Singh Chauhan, Mr. Harsh Pathak, Mr. A.A. Maitrya, Mr. Praveen Khattar, Mrs. Sudha Gupta, Mr. Avik Datta and Mr. V.K. Monga, Advocates.

Headnote:Indian Penal Code, 1860-Section 304A/34-Medical negligence-Concept of-Liability under civil law and under the criminal law-Distinction-FIR filed by respondent alleging carelessness of doctors and nurses and non availability of oxygen cylinders resulting in death of his father-Complainants father was admitted as a patient in appellants hospital-Patient felt difficulty in breathing-Oxygen cylinder available was found empty-There was no arrangement to make the gas cylinder functional-Patient died as much time was wasted-Charges under Section 304A/34 IPC were framed against two doctors-Revision filed by doctors submitting that there was no ground for framing charges against them as the patient was treated with utmost care and caution and given all the required medical assistance by doctors and para medical staff-Whether accused can be proceeded against under Section 304A IPC-(No)-Averments made in the complaint, even if held to be proved, do not make out a case of criminal rashness or negligence on the part of appellant doctors.

       If all the averments made in the complaint even if held to be proved, do not make out a case of criminal negligence on the part of accused-appellant. It is not the case of the complainant that the accused-appellant was not a qualified doctor to treat the patient, whom he agreed to treat. It is a case of non-availability of oxygen cylinder either because of the hospital having failed to keep available a gas cylinder or because after gas cylinder being found empty. Then, probably the hospital may be liable in Civil Law, but the accused-appellant cannot be proceeded against under Section 304-A IPC on the parameters of Balams test.

Judgement Key Points

Key Points: - The judgment clarifies that negligence in criminal law requires a gross or very high degree of negligence, not merely civil negligence (!) (!) (!) . - It endorses Bolam’s test as applicable to professional negligence in civil and, with adaptation, to criminal cases to determine if a doctor’s conduct met the standard of an ordinarily competent practitioner (!) (!) (!) (!) . - It distinguishes between the standards for civil liability and criminal liability in medical negligence, emphasizing mens rea and the higher threshold for criminal prosecution (!) (!) (!) . - It rejects applying res ipsa loquitur as a sole basis for criminal negligence and calls for independent medical opinion before prosecuting a doctor (!) (!) (!) . - It provides guidelines to govern prosecution of doctors, including requiring credible medical opinion and caution in arrest, to avoid frivolous prosecutions (!) (!) . - The case specifically quashes the criminal proceedings against the accused for 304A/34 IPC, holding no gross negligence proven under Bolam’s standard on the facts (!) (!) (!) .

What is the standard of negligence applicable to medical professionals when prosecuting under Section 304A IPC?

What is the role of Bolam’s test and how does it distinguish civil negligence from criminal negligence in medical cases?

What guidelines or conditions did the Supreme Court lay down for prosecuting doctors for acts of rashness or negligence under criminal law?


JUDGMENT

R.C. Lahoti, C.J.I.—Ashok Kumar Sharma, the respondent No. 2 herein filed a First Information Report with Police Station, Division No. 3, Ludhiana, whereupon an offence under Section 304A read with Section 34 of the Indian Penal Code (for short “the IPC”) was registered. The gist of the information is that on 15.2.1995, the informant’s father, late Jiwan Lal Sharma was admitted as a patient in a private ward of CMC Hospital, Ludhiana. On 22.2.1995 at about 11 p.m., Jiwan Lal felt difficulty in breathing. The complainant’s elder brother, Vijay Sharma who was present in the room contacted the duty nurse, who in her turn called some doctor to attend to the patient. No doctor turned up for about 20 to 25 minutes. Then, Dr. Jacob Mathew, the appellant before us and Dr. Allen Joseph came to the room of the patient. An oxygen cylinder was brought and connected to the mouth of the patient but the breathing problem increased further. The patient tried to get up but the medical staff asked him to remain in the bed. The oxygen cylinder was found to be empty. There was no other gas cylinder available in the room. Vijay Sharma went to the adjoining room and brought a gas cylinder therefrom. However, there was no arrangement to make the gas cylinder functional and in-between, 5 to 7 minutes were wasted. By this time, another doctor came who declared that the patient was dead. The latter part of the FIR states (as per the translation in English as filed by the complainant):

“.....the death of my father was occurred due to the carelessness of doctors and nurses and non-availability of oxygen cylinder and the empty cylinder was fixed on the mouth of my father and his breathing was totally stopped hence my father died. I sent the dead body of my father to my village for last cremation and for information I have come to you. Suitable action be done Sd/- —— As per statement of intimator the death of Jiwan Lal Sharma has occurred due to carelessness of doctors and nurses concerned and to fit empty gas cylinder.”

2. On the abovesaid report, an offence under Sections 304A/34, IPC was registered and investigated. Challan was filed against the two doctors.

3. The Judicial Magistrate, First Class, Ludhiana framed charges under Section 304A, IPC against the two accused persons, both doctors. Both of them filed a revision in the Court of Sessions Judge submitting that there was no ground for framing charges against them. The revision was dismissed. The appellant filed a petition in the High Court under Section 482 of the Code of Criminal Procedure praying for quashing of the FIR and all the subsequent proceedings.

4. It was submitted before the High Court that there was no specific allegation of any act of omission or commission against the accused persons in the entire plethora of documents comprising the challan papers filed by the police against them. The learned Single Judge who heard the petition formed an opinion that the plea raised by the appellant was available to be urged in defence at the trial and, therefore, a case for quashing the charge was not made out. Vide order dated 18.12.2002, the High Court dismissed the petition. An application for recalling the abovesaid order was moved which too was dismissed on 24.1.2003. Feeling aggrieved by these two orders, the appellant has filed these appeals by special leave.

5. According to the appellant, the deceased Jiwan Lal was suffering from cancer in an advanced stage and as per the information available, he was, in fact, not being admitted by any hospital in the country because his being a case of cancer at terminal stage. He was only required to be kept at home and given proper nursing, food, care and solace coupled with prayers. But as is apparent from the records, his sons are very influential persons occupying important positions in Government. They requested the hospital authorities that come what may, even on compassionate grounds their father may be admitted in the hospital for regula





















































































































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