Allahabad High Court: In an application filed under Section 482 of the Criminal Procedure Code, 1973 (‘CrPC’), the accused sought to quash the summoning order passed by the Additional Chief Judicial Magistrate (‘ACJM’) for offences under Sections 304A, 315, 323, and 506 of the Penal Code, 1860 (‘IPC’), along with the entire proceedings pending before the ACJM’s court, the Single Judge Bench of Prashant Kumar, J. said that it has become a common practice among private nursing homes and hospitals to entice patients for treatment despite lacking proper infrastructure or qualified medical professionals. Once a patient is admitted, these institutions often begin contacting doctors to administer treatment. The Court noted that such establishments increasingly treat patients as mere “guinea pigs” or “ATM machines,” seeking to exploit them financially.
While acknowledging that medical professionals should be protected from unwarranted criminal prosecution, the Court emphasised that such protection is meant for those who act with due diligence and caution. It cannot extend to doctors who run ill-equipped nursing homes and lure patients solely for monetary gain.
Upon perusal of the material on record and considering the facts at this stage, the Court concluded that it could not be said that no prima facie offence was made out against the accused. The cognizance order was passed after due consideration of the evidence collected during the investigation. The Court held that the issues raised by the accused involved were disputed questions of fact, which could not be addressed under Section 482 CrPC.
Background
In the instant case, an FIR was lodged on 29-07-2007 by the complainant, alleging medical negligence against the accused, a doctor and owner of Savitri Nursing Home, Deoria. It was stated that the patient, the wife of the informant’s younger brother, was admitted for delivery on 28-07-2007, and although consent for surgery was given by 11:00 A.M. on 29-07-2007, the operation was allegedly delayed until 5:30 P.M., resulting in the death of the foetus. The complainant also alleged that the family was assaulted when they raised objections, additional charges were demanded, and no discharge summary was provided. A Medical Board constituted by the Chief Medical Officer gave a report absolving the accused of fault, and a final report was submitted by the police. However, the complainant filed a protest petition challenging the final report and alleging fabrication and mishandling of evidence. The Magistrate, upon perusal of the case diary and material on record, found a prima facie case of medical negligence, rejected the final report, and issued summons against the accused. The summoning order and the entire proceedings were challenged by the accused through the present application filed under Section 482 CrPC.
Analysis and Decision
The Court noted that the reason cited by the accused for the death of the foetus was that the patient’s family members had not consented to the surgery in time. However, this explanation was found to be inconsistent with the version stated in the FIR, wherein the timeline provided by the informant differed significantly and did not align with other evidence on record. According to the informant, consent for the surgery had been given around 12:00 noon, but the operation was delayed due to the unavailability of an anaesthetist at the nursing home. The surgery was carried out only after the anaesthetist arrived, which, as alleged, led to the unfortunate outcome and formed the basis of the negligence claim.
The Court said that a bare perusal of the post-mortem report of the foetus, indicated that the cause of death was “Prolonged Labour.” However, it noted that there was nothing on record to show that the post-mortem report was ever placed before the Medical Board. The Court further observed that the Medical Board’s report made no mention of the post-mortem findings, thereby casting doubt on the thoroughness of the inquiry conducted.
The Court said that, it is a common phenomenon that whenever there is a death, there tends to be an increasing tendency among the family members of the deceased to look for a human factor to blame for the untoward event, often targeting doctors as “sitting ducks.” In such circumstances, the Court emphasised the need for adequate protection for medical professionals. It observed that without such protection, a surgeon may hesitate or fear to perform a surgery, apprehensive of potential prosecution in the event of an unfortunate outcome, which could ultimately affect the quality and availability of emergency medical care.
However, the Court said that such protection for medical professionals must be balanced and cannot be absolute. Referring to the ratio laid down in several judicial precedents, the Court observed that this protection can only be extended when the medical professional has performed their duty with the level of skill and care expected of a reasonably competent doctor under similar circumstances. The Court clarified that criminal liability may arise if a doctor fails to exercise ordinary care while treating a patient. In such cases, it is essential to examine the presence of mens rea, and the true test for establishing criminal negligence is whether the doctor was guilty of failing to act with ordinary care.
The Court highlighted that the instant case was not one where the accused lacked the requisite medical qualifications. Instead, the matter turned on whether the accused had exercised reasonable care in providing timely medical treatment or had acted negligently. It was noted that although consent for surgery was obtained around 12:00 noon, the operation was performed only at 5:30 P.M. The delay, caused by the unavailability of an anaesthetist, ultimately resulted in the death of the child, raising a serious question regarding the standard of care exercised by the accused.
The Court distinguished between a simple lack of care, which attracts civil liability, and a very high degree of negligence that constitutes criminal liability. It emphasised that prosecution in a criminal case is distinct from civil liability, and the existence of the latter does not preclude the former. The Court observed that this case was one pure misadventure, where the doctor admitted the patient and obtained consent for surgery from the family but failed to perform the operation in a timely manner due to the unavailability of an anaesthetist. According to the anaesthetist’s statement, he was called only at 3:30 P.M., and the resulting delay was attributable solely to the accused. The Court also noted contradictions in the timings of admission, consent, and surgery, alongside the existence of two operation theatre notes and a post-mortem report. Since these documents were not presented before the Medical Board, its opinion was deemed unreliable. Consequently, the Court held that a prima facie offence was established against the accused, and there was no ground to invoke inherent powers under Section 482 CrPC to interfere with the ongoing proceedings.
The Court observed that it had become a common practice for private nursing homes and hospitals to admit patients despite lacking the necessary doctors or infrastructure. Upon admission, such facilities would summon doctors as needed, often treating patients merely as guinea pigs or ATM machines to extort money. While the Court acknowledged the necessity of protecting medical practitioners from undue prosecution for genuine medical negligence, so as to avoid creating a climate of fear among doctors in performing their duties, it firmly held that such protection did not extend to those who operated nursing homes without adequate facilities or qualified doctors, and who lured patients primarily for financial gain.
The Court said that the instant case was an example where the consent of the patient’s family was obtained around 12 noon, yet the operation was not performed until 4 or 5 P.M., with no adequate explanation offered for the delay. The postmortem report clearly indicated that the foetus died due to prolonged labour, which, in the Court’s view, pointed to a mala fide intention on the part of the doctor. It further observed that the crucial aspects in the case, namely, the time of admission, the time of taking consent, and the time of surgery, must be examined through evidence. If the consent was given at noon, the delay of several hours in conducting the surgery was wholly unjustified, and such negligence could be squarely attributed to the accused.
The Court, upon perusal of the material on record and the facts of the case at this stage, concluded that it could not be said that no prima facie offence was made out against the accused. The cognizance order dated 15-09-2008 had been passed after considering the material gathered during the investigation. The arguments raised by the accused pertained to disputed questions of fact, which could not be adjudicated under Section 482 CrPC. At this preliminary stage, the Court’s role was only to ascertain the existence of a prima facie case, in line with the law laid down by the Supreme Court.
Therefore, the application was found to be devoid of merit and was accordingly dismissed. However, it was clarified that any observations made in this order would not influence the trial, which shall proceed independently on its own merits. The accused were granted liberty to raise all available defences during the trial.
[Dr Ashok Kumar Rai v. State of UP, 2025 SCC OnLine All 4362, decided on 24-07-2025]
Advocates who appeared in this case:
Counsel for Accused:- Senior Advocate, Shailendra Kumar Rai
Counsel for Opposite Party:- Govt. Advocate, S.K.Mishra
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