Delhi Medical Council disciplinary committee order is not binding in Delhi Courts
Delhi High Court
New Delhi: In a recent judgment, the Delhi High Court observed that the observations made by the Medical Council cannot be binding upon criminal courts, as the function of the criminal court is to independently assess whether the ingredients of a criminal offence are prima facie made out.
These observations were made by an HC bench comprising Justice Amit Mahajan while considering a case concerning the death of a patient while undergoing treatment at a Delhi hospital.
Even though the Court expressed sympathy for the bereaved parents of the young patient, it also clarified that the loss and tragedy suffered by them cannot be the basis for reconsidering and reviving criminal proceedings which were earlier found to be an abuse of judicial process.
The applicants/ parents of the deceased patient alleged that their son, who was suffering from Duchenne muscular Dystrophy, died due to medical negligence of the accused doctors working with the treating hospital and due to administration of antobiotics namely azithromycin and levofloxacin, which caused a drug-allergic reaction leading to his death.
Taking cognisance, the learned MM directed the Director of All India Institute of Medical Sciences (AIIMS) to constitute a Medical Board comprising doctors specialized in the field to examine the matter and render its opinion on whether the death of the patient was attributable to negligence on the part of the treating doctors.
The parents also filed a case before the NCDRC, which also sought an opinion from the AIIMS Medical Board. A criminal complaint seeking registration of an FIR was also filed. Consequently, the opinion of the Director of Health Services, GNCTD, was sought. Meanwhile, the matter reached the Delhi High Court, where the treating doctors and the hospital assailed the order of cognizance dated 04.06.2010.
In its report dated 26.10.2010, the Medical Board of AIIMS, comprising of seven expert members, opined that there was no material to suggest any gross negligence on the part of the treating doctors or the hospital. "The sequence of events suggest the patient had cardio respiratory arrest which could have been due to an arrhythmia or drug reaction following which the patient was shifted to ICU where cardio respiratory resuscitation was carried out. However, the patient could not be revived and died in the ICU," observed the AIIMS Medical Board.
The DHS also opined that, prima facie, no gross negligence, rashness, or omission was involved in the treatment of the patient. Thereafter, the matter was referred by the Deputy Commissioner of Police to the learned Delhi Medical Council (DMC) for its opinion.
The Disciplinary Committee of the learned DMC, consisting of six doctors, in the orders dated 01.10.2010 and 03.11.2010 observed that the main treating doctor had "failed to exercise reasonable degree of knowledge" expected of an ordinary prudent doctor.
It was observed by the Committee that the concerned doctor failed to exercise a reasonable degree of knowledge which was expected of an ordinary prudent doctor, by prescribing administration of a test dose of antibiotics viz. Azithromycin and levofloxacin intravenously contrary to standard protocols and especially in a patient with a known history of drug allergy. Accordingly, the DMC directed the removal of his name from the State Medical Register for a period of one month.
While considering the matter, the Delhi HC bench in its judgment dated 11.02.2011, took into consideration the opinion of the DHS, the report of AIIMS, as well as the decision of DMC, and it categorically observed that the two boards, one of DHS, and one of AIIMS, had given clean chit to the treating doctors and hospital by observing that there was no gross negligence/recklessnes attributable to the treating doctor. Accordingly, the Court set aside the order of cognizance and quashed the criminal proceedings.
However, challenging this, the applicants first approached the Supreme Court and later the High Court, seeking recall of the earlier order. The High Court noted that the principal grievance of the applicants was that the Court wrongly discarded the findings of the Disciplinary Committee of the Delhi Medical Council, which had found the treating doctor guilty of "medical negligence and misconduct".
However, referring to the earlier order of the High Court, the bench observed that such a submission on behalf of the applicants proceeds on an erroneous assumption, as the judgment dated 11.02.2011 does not discard the DMC report and has addressed the same.
It also noted that the emphasis placed by the applicants on the decision of the Delhi Medical Council dated 03.11.2010 to contend that "medical negligence" having been recorded against the treating doctor, which has been over-looked and criminal proceedings deserve to be revived, is wholly misconceived.
"A plain and contextual reading of the said decision of the learned DMC reproduced in the preceding paragraphs makes it manifest that the finding of “medical negligence” is confined to a limited professional lapse in the mode of administration of a test dose of antibiotics, and not a finding of gross negligence, recklessness or rash conduct so as to attract criminal culpability. Significantly, the Disciplinary Committee expressly held that the provisional diagnosis of pneumonia, the decision to admit the patient, as well as the choice of antibiotics, were all justified and in conformity with accepted medical practice. The “medical negligence” recorded at the end pertains only to deviation from standard protocol in administering a test dose intravenously in a patient with a known history of drug allergy, for which a minor disciplinary penalty of temporary removal from the medical register for one month was imposed. Such a finding, rooted in regulatory and professional standards, cannot be elevated to the level of criminal negligence required under Section 304-A of the IPC, when it is trite that every lapse or error of judgment by a medical professional does not give rise to criminal prosecution, unless the conduct complained of is so gross or culpable as to show a disregard for life and safety," observed the Court.
The Court also observed that the proceedings before the DMC were disciplinary proceedings governed by the Delhi Medical Council Act, 1977. The standard applied therein is materially different from the standard required to prosecute a person for a criminal offence under Section 304-A of the IPC.
At this outset, it noted,
"Finding of professional misconduct or negligence in disciplinary proceedings cannot automatically translate into criminal culpability and even otherwise, the findings of the Disciplinary Committee of the learned DMC, did not disclose the element of “gross negligence or recklessness” by the accused Doctors, required to sustain criminal prosecution for medical negligence. Thus, the decision of the learned DMC, even if taken at its highest, does not dilute the basis of the impugned judgment."
"The contention that the DMC being a statutory body, its opinion ought to have been treated as conclusive, is also legally untenable. The observations of the Medical Council cannot be binding upon the criminal courts as the function of the criminal court is to independently assess whether the ingredients of a criminal offence are prima facie made out," it further held.
The Court termed the present application as an attempt to reargue the matter on merits, to reopen concluded issues, and to substitute this Court’s judicial assessment with the Applicants’ subjective perception. While it expressed sympathy for the bereaved parents of the deceased patient, it also held that the loss suffered by them cannot furnish a legal foundation to revive criminal proceedings which, upon due consideration of the entire material, were found to be an abuse of the process of law.
It held,"...there is nothing placed on record to reflect any infirmity in the impugned judgment and no document has been brought forth to show that any opinion with respect to “gross negligence” by the accused doctors to attract Section 304A of the IPC, was not considered while passing the impugned judgment...No error apparent on the face of the record has been demonstrated and in the opinion of this Court, the judgment dated 11.02.2011 reflects a reasoned, balanced, and legally sound exercise of jurisdiction."
