Madras HC upholds Medical Council order barring doctor from Practice for two years for issuing fake certificate

In fact, the TNMC had directed the Karnataka Medical Council to suspend two other doctors associated with the city hospital for "short of the standard of care, integrity and conduct". The state medical council had suggested removing the name of the former medical superintendent for one year and the treating physician's name for six months.

Also Read: HC Upholds Medical Council Order Barring Doctor from Practice for Two years

Challenging the suspension order dated 04.05.2021, the petitioner doctor had approached the High Court. Previously, while considering the matter, the single judge bench of the Madras High Court had upheld the order of the Medical Council. Confirming the punishment of removing the name of the doctor for two years, the single judge bench had held that the act of the doctor in issuing false medical certificate to a patient for transferring his properties was no less than an interesting plot of a criminal thriller.

Dismissing the complaint, the court had opined that the punishment given by the Medical Council to the doctor was just and the single judge bench had observed, "Such punishment imposed on the petitioner, in the view of this Court, does not call for any interference."

However, the doctor challenged the order and approached the Division bench of Madras High Court. Mr.Dama Sheshadri Naidu, the learned Senior Counsel appearing on behalf of the doctor referred to the hospital records and the deposition of Dr.Praveen B Nilgar as well as Dr.Anand Mohan Pai. Referring to these, the doctor's counsel argued that the patient's condition had been mentioned as "Sensorial" which means that the patient was conscious.

Therefore, the doctor's counsel argued that the mere fact that the patient was hospitalized and was in and out of the I.C.U would only vouch for the correctness of the statement made by the doctor that he was confined to his bed and the purpose of the certificate was only to certify that he was unable to travel to the office of the Sub-Registrar. With this submission, the doctor's counsel contended that the certificate was neither false nor misleading.

It was further argued by the doctor's counsel that there is no specific requirement that only the treating doctor could issue medical certificate and since Dr. Radhakrishnan was a relative and an expert in the filed, he was periodically being consulted and was taken into confidence by other treating doctors at the hospital. 

Further, the doctor contended that the procedure adopted by TNMC Disciplinary Committee was in gross violation of the principles of natural justice as the doctor did not get a chance to cross examine Dr. P Basumani. It was the statement by Dr Basumani, which claimed that the patient was unconscious.

On the other hand, the counsel for TNMC submitted that the medical certificate was grossly inappropriate both in its form and as well as its contents and it directly violated the regulations. Claiming that the doctor had committed grave professional misconduct, the Council submitted that they had considered each and every aspect of the explanation during the enquiry and the Disciplinary Committee had summoned the relevant witnesses and the appellant participated in the enquiry. The council also argued that there was no specific request for cross examination of Dr. Basumani. 

Meanwhile, the counsel for the daughter of the deceased patient submitted the doctor was not any stranger as he was the father-in-law of the son of the deceased. Except for visiting the patient in the I.C.U, he had not treated the patient and had no occasion to issue the medical certificate. The counsel for the deceased's daughter further submitted that on the basis of the false certificate, the Sub-Registrar had made a false entry as if her father Mr.Pitchaimani was at his residence in No. 3/3B, Sivasamy avenue, Dr. MGR Road, Palavakkam, Chennai – 41 and as if he presented the document and paid the fees. Therefore, she had been deprived of her lawful claim on the property worth Rs 50 crore belonging to her father, submitted the counsel.

After considering the submissions made by all the parties, the HC division bench referred to the concerned Regulations and also took note of the normal practice requirements regarding issuing medical certificate to any patient. Referring to the norms, the bench opined, "Obviously, the medical certificate issued by the appellant, which is extracted above, is not in conformity with the above requirements as well as to Regulation 1.3.3."

In order to judge if the doctor had given false and misleading certificate, the bench referred to Regulation 7.7 and Appendix4(m) of the Regulations. The concerned Regulations clearly mention that "Any registered practitioner who is shown to have signed or given his name and authority any such certificate, notification, report or document of a similar character which is untrue, misleading or improper is liable to have his name deleted from the Register."

Referring to these, the court observed,

"Therefore, the gravamen of the allegation is that as on 08.10.2015, the patient Mr.Pitchaimani was admitted into the Intensive Care unit of Fortis Malar Hospital, whereas, on a reading of the above certificate it is misleading as if he was residing in the house address mentioned in the certificate. The purpose of the certificate was to excuse the attendance in the public office, namely before the Sub-Registrar and certifying as if the patient is fit for the said purpose and as if he only is unable to undertake the travel is clearly misleading, as the facts are otherwise."

"Further, the certificate clearly gives a false information that the patient is oriented while the patient was completely disoriented and even regarding consciousness, he was unconscious of and on. Therefore, the information contained in the certificate is a deliberate false information. In that view of the matter, the said allegations, which is a direct contravention Regulation 7.7 amounts to misconduct. As a matter of fact, Regulation 7.1 expressly mentions that violation of any of the Regulations is a misconduct. Therefore, we find that the allegations made against the appellant amounts to professional misconduct in accordance to Tamil Nadu Medical Council (Professions Conduct, Etiquette and Ethics) Regulations, 2003," the bench further noted.

Opining that the medical certificate had violated the norms, the bench noted,

"Now, coming to the proof, the appellant admits that he had issued the certificate. The certificate is extracted supra and the same was on the file of the first and second respondents. Therefore, the same, by itself, stands testimony for the violation of the form of medical certificate."

Establishing that the medical certificate was misleading, the bench stated,

"From the very fact that an endorsement was made in the document by the Sub-Registrar that Mr.Pitchaimani presented the document for registration from his house address mentioned supra and that he paid the fees, would clearly demonstrate the misleading nature of the information contained in the above certificate. As far as the falsity is concerned, the condition of the patient, from the medical certificate, which is extracted supra, it is mentioned that the patient was oriented. As per the Hospital records, which is extracted supra, he was disoriented."

After considering the definition of the word "disoriented", the bench observed, "Thus, Mr.Pitchaimani was not in a position to comprehend what was the time, in which place he was there and who the person, namely, Sub-Registrar was."

"The very fact, that he could not even sign and only his left thumb impression is taken in every page of the document that too in a manner as if it is not made by the same person, but, with the help of another in awkward and reverse directions, categorically demonstrates that he was disoriented. The learned Senior Counsel, appearing on behalf of the appellant, repeatedly stressed on the word "Sensorial" to mean that the person was conscious, however, overlooked that the patient was clearly disoriented. Therefore, when the hospital records, which are called for by the first and second respondents, which are produced before this Court, continuously, clearly and categorically record that the patient was disoriented all along, there is ample proof on record that the certificate is not only misleading, but also contains false information," the bench further noted.

The bench also held that the TNMC had not violated any rules as it noted that "even in the absence of the statement of Dr.P.Basumani, from the very records of the hospital, the falsity of the certificate stands proved."

While considering the proportionality of punishment, the bench observed

"This is a certificate issued willfully knowing the true state of affairs. This certificate is issued to a close relative with the sinister object of getting undue share in the above mentioned 19 items of properties to his own son-in-law. Therefore, the action of the appellant is grave in nature."

At this outset, the bench also took note of the educational qualification of the doctor and noted,

"When the appellant has let down all the education imparted on him by these institutions just because the real estate value of these sub-urban properties has skyrocketed beyond its worth, we feel that doubles up the seriousness of the misconduct and accordingly, we do not find that the punishment imposed is in any manner disproportionate or unduly severe on the appellant."

To read the order, click on the link below.

https://medicaldialogues.in/pdf_upload/madras-hc-dr-radhakrishnan-184048.pdf

Also Read: 3 doctors face Medical Council wrath for allegedly issuing False Medical Certificate to patient