7.
(SC) 05-08-2005
A. Indian Penal Code, 1860 (45 of 1860), Section 304-A – Negligence – Tort – Medical Negligence -- Criminal liability -- Negligence is the breach of a duty caused by omission to do something which a reasonable man guided by those considerations which ordinarily regulate the conduct of human affairs would do, or doing something which a prudent and reasonable man would not do – Negligence becomes actionable on account of injury resulting from the act or omission amounting to negligence attributable to the person sued – Essential components of negligence are three: ’duty’, ’breach’ and ’resulting damage’.
-- Negligence in the context of medical profession necessarily calls for a treatment with a difference. To infer rashness or negligence on the part of a professional, in particular a doctor, additional considerations apply. A case of occupational negligence is different from one of professional negligence.
-- A simple lack of care, an error of judgment or an accident, is not proof of negligence on the part of a medical professional.
-- So long as a doctor follows a practice acceptable to the medical profession of that day, he cannot be held liable for negligence merely because a better alternative course or method of treatment was also available or simply because a more skilled doctor would not have chosen to follow or resort to that practice or procedure which the accused followed.
-- When it comes to the failure of taking precautions what has to be seen is whether those precautions were taken which the ordinary experience of men has found to be sufficient; a failure to use special or extraordinary precautions which might have prevented the particular happening cannot be the standard for judging the alleged negligence.
-- Standard of care, while assessing the practice as adopted, is judged in the light of knowledge available at the time of the incident, and not at the date of trial.
-- When the charge of negligence arises out of failure to use some particular equipment, the charge would fail if the equipment was not generally available at that particular time (that is, the time of the incident) at which it is suggested it should have been used.
(Para 51 (1)(2))
B. Indian Penal Code, 1860 (45 of 1860), Section 304-A – Medical negligence – Tort – Criminal liability -- A professional may be held liable for negligence on one of the two findings: either he was not possessed of the requisite skill which he professed to have possessed, or, he did not exercise, with reasonable competence in the given case, the skill which he did possess -- Standard to be applied for judging, whether the person charged has been negligent or not, would be that of an ordinary competent person exercising ordinary skill in that profession -- It is not possible for every professional to possess the highest level of expertise or skills in that branch which he practices -- A highly skilled professional may be possessed of better qualities, but that cannot be made the basis or the yardstick for judging the performance of the professional proceeded against on indictment of negligence -- Test for determining medical negligence as laid down in Bolam’s case [1957] 1 W.L.R. 582, 586 holds good in its applicability in India.
(Para 51 (3)(4))
C. Indian Penal Code, 1860 (45 of 1860), Section 304-A – Medical negligence – Tort – Criminal liability – Mens-rea -- Res ipsa loquitur -- Jurisprudential concept of negligence differs in civil and criminal law -- What may be negligence in civil law may not necessarily be negligence in criminal law -- For negligence to amount to an offence, the element of mens rea must be shown to exist -- For an act to amount to criminal negligence, the degree of negligence should be much higher i.e. gross or of a very high degree -- Negligence which is neither gross nor of a higher degree may provide a ground for action in civil law but cannot form the basis for prosecution.
-- The word ’gross’ has not been used in Section 304A of IPC, yet it is settled that in criminal law negligence or recklessness, to be so held, must be of such a high degree as to be ’gross’. The expression ’rash or negligent act’ as occurring in Section 304A of the IPC has to be read as qualified by the word ’grossly’.
-- To prosecute a medical professional for negligence under criminal law it must be shown that the accused did something or failed to do something which in the given facts and circumstances no medical professional in his ordinary senses and prudence would have done or failed to do. The hazard taken by the accused doctor should be of such a nature that the injury which resulted was most likely imminent.
-- Res ipsa loquitur is only a rule of evidence and operates in the domain of civil law specially in cases of torts and helps in determining the onus of proof in actions relating to negligence. It cannot be pressed in service for determining per se the liability for negligence within the domain of criminal law. Res ipsa loquitur has, if at all, a limited application in trial on a charge of criminal negligence.
(Para 51 (5-8))
D. Indian Penal Code, 1860 (45 of 1860), Section 304-A – Code of Criminal Procedure, 1973 (2 of 1974), Section 154,156,190 -- Medical negligence – Tort – Criminal liability -- Guidelines - re: prosecuting medical professionals -- Statutory Rules or Executive Instructions incorporating certain guidelines need to be framed and issued by the Government of India and/or the State Governments in consultation with the Medical Council of India -- So long as it is not done, Court propose to lay down certain Guidelines for the future which should govern the prosecution of doctors for offences of which criminal rashness or criminal negligence is an ingredient :
-- A private complaint may not be entertained unless the complainant has produced prima facie evidence before the Court in the form of a credible opinion given by another competent doctor to support the charge of rashness or negligence on the part of the accused doctor.
-- Investigating officer should, before proceeding against the doctor accused of rash or negligent act or omission, obtain an independent and competent medical opinion preferably from a doctor in government service qualified in that branch of medical practice who can normally be expected to give an impartial and unbiased opinion applying Bolam’s test to the facts collected in the investigation.
-- A doctor accused of rashness or negligence, may not be arrested in a routine manner (simply because a charge has been levelled against him). Unless his arrest is necessary for furthering the investigation or for collecting evidence or unless the investigation officer feels satisfied that the doctor proceeded against would not make himself available to face the prosecution unless arrested, the arrest may be withheld.
(Para 55)
E. Indian Penal Code, 1860 (45 of 1860), Section 304-A, 34 – Medical negligence – Tort – Criminal liability -- Criminal rashness or negligence -- It is not the case of the complainant that the accused-appellant was not a doctor qualified 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 of the 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 304A IPC on the parameters of Bolam’s test -- Prosecution of the accused appellant under Section 304A/34 IPC is quashed.
(Para 56, 57)
