Kerala High Court: In a case where the petitioner, a specialist doctor and Consultant Gastroenterologist at a private hospital in Ernakulam, was booked by the Ernakulam Town North Police for the offence under Section 304A IPC following the death of a patient due to renal complications, a Single Judge Bench of G. Girish, J. held that there was absolutely no material on record to suggest that the petitioner’s actions, prescribing medicines and ordering laboratory evaluation of the patient’s vitals, constituted gross negligence beyond what is expected of a doctor of similar standing.
On the contrary, the evidence indicated that the course of treatment adopted by the petitioner was consistent with standard medical practice and would have been followed by other competent professionals under similar circumstances.
In light of these observations, the Court concluded that the criminal prosecution amounted to an abuse of the process of law and warranted interference at the threshold. Consequently, the prayer in the petition to quash the proceedings pending before the Additional Chief Judicial Magistrate Court, Ernakulam, was allowed.
Background
A 29-year-old patient who had undergone a kidney transplant at a private hospital in Kochi in July 2011, was re-admitted on 14-05- 2012, with abdominal pain and vomiting. The petitioner, a doctor in the hospital’s Gastroenterology Department, treated him while the Nephrology Department continued daily monitoring due to his prior transplant. After showing improvement, he was scheduled for discharge on 25-05-2012, pending a final nephrology review.
However, around midnight, he experienced breathlessness. A duty nurse administered oxygen and noted normal oxygen saturation. His condition worsened with fever and vomiting. At around 4:30 a.m. on May 26, the nurse contacted the petitioner, who, from home, advised medication and ordered blood and urine tests. By 8:00 a.m., Praveen was moved to the Nephrology ICU, where he remained under treatment until he passed away at 2:00 p.m. on May 27 due to renal complications. No postmortem was conducted.
The allegation against the petitioner was that advising treatment over the phone, instead of arranging an immediate physical examination by a nephrologist, contributed to the patient’s death.
Issue
Whether the conduct of the petitioner prescribing some medicine over telephone and directing the laboratory analysis of blood and urine of the patient, instead of requiring the duty Nurse to arrange examination of the patient by the Nephrologist, would amount to criminal negligence to fasten him with the culpability under Section 304A IPC.
Analysis and Decision
After taking note of Jacob Mathew v. State of Punjab, (2005) 6 SCC 1, the Court noted that the Supreme Court had previously issued words of caution to sensitise Trial Courts about the need to exercise extreme diligence while dealing with cases of medical negligence, where doctors were booked under Section 304A of the Penal Code, 1860, for the death of patients treated by them.
It observed that the general psyche of society was inclined to cast aspersions on the conduct of doctors and other medical professionals whenever a patient died under their care. The Court found it unfortunate that this tendency to blame medical professionals was significantly more prevalent than the gratitude shown when they succeeded in saving lives.
However, the Court clarified that this did not mean the law must remain inactive in cases where genuine negligence occurred. It stressed that authorities must not be swayed by the emotional reactions of aggrieved individuals, whose desperation could lead them to unjustly fault doctors who had made earnest efforts to save their patients.
The Court noted that the petitioner had medically managed the patient’s earlier complaints and that the patient had been under continuous observation by specialists, including daily evaluations by a Nephrologist. It further observed that the patient was considered fit for discharge based on assessments by the departments of Nephrology and Gastroenterology. The Court highlighted that the unexpected medical deterioration occurred past midnight on 26-05-2012, prompting a call from the duty nurse to the petitioner at 04:30 a.m.
The Court also took note of the fact that the petitioner, instead of deflecting responsibility, prescribed medication and ordered laboratory tests in an attempt to address the patient’s condition without delay. Importantly, no member of the Expert Panel found the treatment administered to be inappropriate or negligent. A senior expert in the field confirmed that he would have taken the same course of action under the circumstances.
Considering these facts, the Court concluded that the petitioner’s actions did not amount to criminal negligence under Section 304A IPC. It emphasised that while the hospital might be liable in civil terms for the failure to arrange for a doctor to examine the patient in the early hours, the petitioner’s conduct could not be brought within the ambit of criminal liability.
The Court reiterated that even where a patient’s death results from an error of judgment or an unforeseen accident, such circumstances do not automatically attract criminal liability. It emphasised that mere inadvertence or a certain degree of insufficient care might give rise to civil liability, but would not, by itself, be sufficient to hold a medical professional criminally liable under the law.
The Court clarified that only in cases involving a gross lack of competence, inaction, or a wanton disregard for the patient’s safety, stemming from gross ignorance or gross negligence, can a doctor be made to face criminal charges. It firmly stated that not every mishap or unfortunate death during medical treatment should lead to the prosecution of the treating doctor, underscoring the need for clear evidence of criminally negligent conduct before initiating such proceedings.
As far as the present case was concerned, the Court held that there was absolutely nothing on record to indicate that the petitioner’s act of prescribing medicines and directing laboratory evaluation of the patient’s vitals amounted to gross negligence of a kind not expected from a doctor of similar standing. On the contrary, the materials on record demonstrated that the course of action adopted by the petitioner was in line with what any other competent medical professional would have followed under similar circumstances.
Given these findings, the Court concluded that the criminal prosecution initiated against the petitioner amounted to an abuse of the process of court and should be terminated at the threshold. Accordingly, the prayer in the petition to quash the proceedings pending before the Additional Chief Judicial Magistrate Court, Ernakulam, was allowed.
[Dr. Joseph John v. State of Kerala, CRL.MC No. 5692 of 2018, decided on 19-05-2025]
Advocates who appeared in this case:
For Petitioner: BY ADVS.C.R. SYAMKUMAR P.A. MOHAMMED SHAH SOORAJ T. ELENJICKAL K. ARJUN VENUGOPAL V.A. HARITHA SIDHARTH B PRASAD R. NANDAGOPAL GAYATHRI MURALEEDHARAN
For Respondent: SANGEETHARAJ N.R., PUBLIC PROSECUTOR
Buy Penal Code, 1860 HERE
