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2025 Supreme(Mad) 4508

BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT
V. LAKSHMINARAYANAN, J.
M.G. Ethayarajan - Appellant
Versus
Director, Directorate of Medical and Rural Health Services, Chennai - Respondent 
W.P. (MD) No. 5568 of 2025, W.M.P. (MD) Nos. 4062, 4064, 5812 of 2025
Decided On : 03-07-2025


Advocates:
Advocate Appeared:
For the Appellants : Sricharan Rangarajan, D. Saravanan
For the Respondent: S. Shaji Bino

The suspension of a medical practitioner's license was quashed due to violation of natural justice and lack of jurisdiction in enforcing external regulations.

Headnote:(A) Tamil Nadu Private Clinical Establishments (Regulation) Act, 1997 - Sections 5 and 6 - Violation of principles of natural justice and exceeding jurisdiction - The order suspending the appellant's hospital license was quashed due to non-service of inquiry reports and lack of evidence for claims made against the appellant. (Paras 73, 74)

(B) Natural Justice - Violation - The court noted that essential documents were not provided to the petitioner, violating natural justice principles essential for fair hearing. (Paras 40, 41)

(C) Jurisdiction - The court determined that the competent authority had no jurisdiction to impose sanctions based on regulations outside its purview, notably those from the National Medical Commission. (Paras 72, 73)

Facts of the case:
The petitioner, a medical doctor operating a clinical establishment, challenged a suspension order related to the use of medical equipment and qualifications. The Joint Director cited complaints regarding the petitioner’s practice without specialist consultation and exorbitant charges. The petitioner argued violations of natural justice and jurisdiction in the decision-making process.

Findings of Court:
The Court found that the decisions and reports relied upon to suspend the license were not shared with the petitioner, affecting his ability to respond adequately to the charges. Additionally, it was ruled that the application of standards from the National Medical Commission in this context was inappropriate.

Issues: The core issues included the adequacy of the procedural fairness afforded to the petitioner, whether the authority exceeded its jurisdiction by referencing external regulations, and the valid grounds for disciplinary action.

Ratio Decidendi: The court emphasized that failing to provide the petitioner with copies of critical documents used in the decision-making process violated the principles of natural justice. Furthermore, the second respondent's actions exceeded jurisdiction as they improperly enforced regulations outside their authority.

Result: Writ Petition allowed; order of suspension quashed.

Table of Content
1. background of medical practice and allegations against petitioner. (Para 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8)
2. committee's actions based on administrative findings. (Para 9 , 10)
3. preliminary proceedings and responses. (Para 12 , 13)
4. arguments regarding natural justice violations. (Para 14 , 15 , 16 , 17 , 18 , 19)
5. legal framework of the relevant act. (Para 20 , 21 , 22)
6. contentions from the respondents. (Para 23)
7. analysis of alternate remedy arguments. (Para 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33)
8. discussion on oral complaints and inspections. (Para 34 , 35 , 36 , 37 , 38 , 39 , 40)
9. violation of principles of natural justice. (Para 41 , 42 , 43 , 44 , 45 , 46)
10. examination of conflicts of interest. (Para 47 , 48 , 49 , 50 , 51 , 52)
11. judicial propriety and fair-play. (Para 53 , 54 , 55)
12. excess of jurisdiction. (Para 56 , 57 , 58)
13. interpretation of relevant statutory provisions. (Para 59 , 60 , 61 , 62)
14. clarification on advertising and qualifications. (Para 63 , 64 , 65 , 66)
15. limitations of authority in disciplinary matters. (Para 67 , 68 , 69 , 70 , 71)
16. conclusions on procedural and jurisdictional flaws. (Para 72 , 73)
17. final order and implications. (Para 74)

ORDER :

1. The present Writ Petition challenges the order passed by the second respondent in his proceedings in Ref.No.550/E4/2025 dated 24.02.2025 and for a further direction to the respondents not to interfere with the practice of medical profession by the petitioner, except in accordance with law.

Brief facts:

2. The petitioner is a medical doctor. He is running a clinical establishment under the name and style of “Irudhayams Hospital” at No.465/ABL Channel Bank Road, VN Puram, Nagercoil, Kanyakumari District. The affidavit and documents reveal that the petitioner completed his undergraduation in Medicine from Madurai Medical College in 1986. He registered himself as a practitioner with the Tamil Nadu Medical Council in 1987. Thereafter, he has undergone the following training:

(i) Special training in General Medicine with the Government Headquarters Hospital at Nagercoil;

(ii) Special training in Pediatrics at the same institution;

(iii) Special training in Dermatology at the same institution;

(iv) Special training in Cardiovascular cartography at at the Center of Advanced Research and Development (CARD), Bangalore;

(v) Diploma in Non-invasive Cardiology from Tashkent Medical University;

(vi) Post Graduate Diploma in Health Sciences in Diabetology from Annamalai University;

(vii) Post Graduate in Clinical Cardiology from IMA AKN Sinha Institute of Continuing Medical and Health Education and Research, New Delhi;

(viii) Post Graduate Diploma in Health Sciences in Echo Cardiography from Annamalai University;

(ix) Master of Health Science (Preventive Cardiology) from Annamalai University;

(x) Master of Health Science (Diabetology) from Annamalai University; and (xi) Special training in Enhanced External Counter Pulsation (EECP) technique from Clarity Medical Equipments.

3. The petitioner claims that he had gained experience in Cardiology by working under one, Dr.Arthanaree, M.D., D.M.(cardio) for nearly 10 years. The said Arthanaree is a Senior Interventional Cardiologist at Apollo Hospitals, Chennai with nearly 45 years of experience in the said field.

4. He claims that using cardiovascular cartography, a non-invasive method, he is able to detect coronary artery blocks. The blocks that are detected are managed again by using non- invasive methods unlike Angiogram, Angioplasty or Bypass surgery, which require a expert Cardiologist or a Cardiovascular Surgeon. He claims to be trained in Enhanced External Counter Pulsation (EECP) techniques and Cartography and utilizing the said knowledge, he has been attending to patients with Nagercoil as his headquarters.

5. The cause of action for the present Writ Petition is a communication that he had received from the second respondent / Joint Director on 19.02.2025. On 19.02.2025, the second

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