Tamil Nadu: HC rescues doctors of gross medical negligence charges, says continuation of criminal proceedings legal abuse

The case pertains to a patient who was admitted to Arvinth Hospital, Namakkal on 18.06.1999. He was involved in a motor accident, sustaining fractures in his left leg and an injury to his right knee. He was promptly taken to the petitioners' (doctors') hospital, where an emergency surgery was conducted, fixing a rod in the left leg bone. Subsequent surgeries were performed, including the insertion of an Orthofix Fixator on 26.07.1999, which was an imported instrument used in specific cases of severe fractures and bone lengthening.

The patient was discharged after 87 days and advised to follow up with regular reviews and physiotherapy. However, due to alleged negligence and non-cooperation, the patient was readmitted to the hospital for an additional 37 days. The patient had suffered a severe fracture on his left leg, leading to a dangerous condition called compartmental syndrome, necessitating immediate surgeries to prevent potential amputation.

The Orthofix Fixator used in his treatment was an expensive imported device from Italy, costing around Rs.1.25 Lakhs. Due to non-payment, the first doctor initiated a civil suit (O.S.No.138 of 2001) seeking to recover Rs.1,10,000/- with interest and obtained an ex parte decree. Subsequently, the patient received summons for a case (O.S.No.138 of 2001), was set ex parte, and an ex parte decree was issued, alleging forgery and fraud.

On the other hand, the patient alleged that the doctors withheld treatment details and breached trust and filed two complaints against the doctors. The first complaint was about alleged medical negligence and inappropriate treatment, and the second complaint was related to the ex parte decree.

The patient had previously lodged complaints with various authorities, including the District Legal Services Authority, District Medical Council, and the police. All these complaints were closed. Subsequently, he filed a criminal complaint (C.C.No.164 of 2014) alleging negligence during the surgeries.

The patient alleged forgery and dishonesty, filing a complaint before the Judicial Magistrate No.I, Namakkal, leading to the cognizance order dated 02.09.2016. The doctors argued that the complaints were time-barred and highlighted a previous complaint dismissed by the State Consumer Disputes Redressal Commission. They contended that the complaints lacked clarity, were mala fide, and constituted an abuse of the legal process.

Meanwhile, the complainant asserted that the doctors provided wrong treatment, causing suffering and mental agony. They alleged the doctors forged documents and treated the patient experimentally. The Trial Court was urged to determine if the doctors' treatment amounted to gross negligence. The patient emphasized that they had prima facie evidence of negligence and forgery, justifying the cognizance.

The Court observed that prima facie negligence was evident, and that the allegations met the guidelines set forth by the Supreme Court in the Jacob Mathew case. The patient’s delay in filing was attributed to pursuing remedies through other forums and was considered justified. The complaints were not quashed, and the doctors were directed to face trial.

Overall, the Court upheld the cognizance order, considering the prima facie evidence of negligence and forgery, and rejected the doctors' plea to quash the complaints.

However, the doctors filed Crl.O.P.No.8755 of 2017 challenging the cognizance order, dated 02.09.2016, in C.M.P.No.4943 of 2015.

The Madras High Court carefully examined the arguments presented and reviewed the available records. The court observed that despite clear instructions and recommendations for continued treatment and physiotherapy, the patient failed to adhere, except for a few visits. Subsequently, he did not show up for further treatments.

The Court further analyzed the facts, highlighting the medical procedures and legal actions. It observed that the complainant had pursued various complaints and legal actions, including approaching consumer and legal authorities. Despite the extensive history of complaints, the complainant ultimately filed criminal complaints. The Court noted that the requisite expert medical opinion to establish negligence was missing, as outlined in the Jacob Mathew case. The Hon'ble Apex Court Jacob Mathew's case [cited supra] dealt in detail with regard to the medical negligence as a tort and as a crime.

Referring to the landmark judgement, the Madras High Court observed;

"In these cases, the respondent (patient/complainant) had failed to obtain any independent opinion from a competent doctor, which is sine qua non while proceeding against the doctors for medical negligence. This is fortified by the order of the State Consumer Disputes Redressal Commission, Chennai, in O.P.No.136 of 2001. As regards non-furnishing of complete report by the petitioners (doctors), it is seen that the respondent had already approached the District Medical Council and the complaint has been closed. Added to it, he had also approached the District Legal Services Authority and the Director General of Police. Thus, after failing in all his attempts, the respondent had filed the complaint with delay."

In a separate complaint, the patient challenged the ex parte decree obtained by the first doctor. The court observed that this complaint was not permissible under Section 195 Cr.P.C. Furthermore, the court criticized the Trial Court's decision to take cognizance of the second complaint, as it was against the law. The Court found that the second complaint concerning the ex parte decree was not maintainable due to jurisdictional issues and procedural irregularities. It considered the lack of gross negligence and mens rea required for criminal liability in medical negligence cases.

It observed;

"Admittedly, the second complaint was filed by a private individual. It is strange to see in the second complaint, the learned Judicial Magistrate No.I, Namakkal, had taken cognizance of the case for the offences under Sections 209, 210, 211, 465, 466, 468 and 469 I.P.C. in C.M.P.No.4943 of 2015, vide order dated 02.09.2016, which is against law and improper. The Trial Court was very well aware about the pending trial of first complaint in C.C.No.164 of 2014 for the offences under Sections 418 and 468 I.P.C. between the respondent and the petitioners. This being so, giving its own interpretation that no penal provisions were mentioned in the first complaint and taking cognizance on the second complaint, is not only absurd, but unheard."

The Court further clarified that there was no indication that the doctors lacked the necessary skills for performing the surgeries, nor was there evidence of gross negligence with an intention to cause harm. Criminal law demands a very high degree of negligence, which was not evident in this case.

Consequently, the Court deemed the proceedings against the doctors an abuse of the legal process and quashed both cases (C.C.Nos.164 of 2014 and 376 of 2016) before the Judicial Magistrate No.I, Namakkal. The Criminal Original Petitions were allowed, and related Criminal Miscellaneous Petitions were closed.

It held;

"Looking the case against the petitioners, it can be safely held that there is nothing to show they lack necessary skill for performing surgeries to the respondent. Further, there is no gross negligence with an intention to cause harm. Under criminal law, the degree of negligence required is of very high degree and the negligence must be culpable or gross negligence and not the negligence merely based upon an error of judgment. Therefore, this Court finds that the continuation of proceedings against the petitioners is nothing, but an abuse of process of law. In view of the above, this Court quashes the proceedings in both C.C.Nos.164 of 2014 and 376 of 2016, on the file of the Judicial Magistrate No.I, Namakkal. Accordingly, the Criminal Original Petitions are allowed. Consequently, connected Criminal Miscellaneous Petitions are closed."

To view the original order, click on the link below: