Medical Error or Civil Negligence Is Not Enough for Criminal Trial Unless Doctor’s Gross Negligence Directly Causes Death

Held: The Supreme Court held that criminal prosecution of a medical professional under Section 304-A IPC cannot continue unless the alleged act amounts to gross negligence of such a high degree that no ordinary prudent medical professional would have acted in that manner. The Court reiterated that medical negligence in civil law and criminal law are different; what may amount to deficiency in service or civil negligence does not automatically become criminal negligence. The Court further held that where the doctor was off duty, merely gave standard medical advice over an SOS phone call, the medicine prescribed was admittedly proper, the alleged procedural failure was by the nurse, and the death was medically linked to acute coronary insufficiency with an 80% coronary blockage, the necessary direct and proximate link for criminal liability was absent.

Summary: The appellant, a senior anaesthetist, was sought to be prosecuted under Section 304-A IPC after a patient who underwent piles surgery at Dhanalakshmi Hospital, Kannur, died due to acute coronary insufficiency. The prosecution alleged that the appellant had instructed a nurse to administer sensorcaine post-surgery instead of personally administering it, and that the drug did not properly enter the epidural space, resulting in pain and triggering the fatal cardiac event. The appellant contended that her duty ended at 5 p.m., she left after ensuring the patient was stable, the SOS call came later, the prescribed analgesic was proper, and the actual administration was done by the nurse. The Supreme Court found that the nurse’s statements were inconsistent, the expert panel had no anaesthetist, the appellant had been exonerated in consumer proceedings on merits, and the deceased’s family had not challenged that exoneration except on compensation quantum. Applying Jacob Mathew, the Court held that the material did not disclose gross criminal negligence and that the alleged chain of causation was too remote to sustain prosecution.

Decision: The Supreme Court allowed the appeal, set aside the Kerala High Court’s order dated 16.10.2024 in Crl. M.C. No. 6415 of 2018, and quashed the criminal proceedings against the appellant in C.C. No. 501/2008 pending before the Judicial Magistrate First Class-I, Kannur. The appellant was discharged from the alleged offences, and all pending applications were disposed of.