Supreme Court pulls up States, UTs for defying orders on ICU, CCU guidelines, contempt notices issued
Supreme Court of India
New Delhi: Slamming the officials of 28 States and Union Territories for their 'casual' failure to comply with the Court's directive to formulate nationwide standards for Intensive Care Units (ICUs) and Critical Care Units (CCUs), the Supreme Court of India has issued contempt notices to them and summoned the concerned Additional Chief Secretary or the senior-most health officials of those States/UTs.
The Apex Court bench, comprising Justices Ahsanuddin Amanullan and N. Kotiswar Singh, also asked all the concerned officers to appear before the Court on November 20, 2025, along with affidavits explaining why no action should be taken against them for their casual approach towards the Court's orders.
"Accordingly, notice is issued to the concerned Additional Chief Secretary/Senior-most Official of the Department of Health of all the concerned States/Union Territories (UTs), as to why action be not taken against them for such casual approach shown towards the Court. The said officers shall remain personally present before this Court, along with their personally affirmed show cause affidavits, on the next date of hearing, i.e., 20.11.2025," the Supreme Court bench ordered.
"It is made clear that the officers who have been directed to appear shall not cite any excuse, including any prior engagements or other programs, which shall be rescheduled to give priority to the order passed today," it further clarified.
Also Read: Supreme Court to Decide on Guidelines for Treating ICU, CCU Patients
Warning to take action if such noncompliance continues, the top court bench observed, "We also make it clear that if, by the said date, there is noncompliance or if compliance is casual or by way of a perfunctory report, this Court would take a very strict view against the officers concerned and the States/UTs in general."
Background:
Medical Dialogues had earlier reported that the Supreme Court took cognisance of the matter while examining a medical negligence case, in a plea filed by Asit Baran Mandal, a resident of West Bengal, who complained against a doctor for negligence, allegedly resulting in the loss of his daughter-in-law after the operation.
Back in August 2016, while considering this case and taking note of the stream of medical negligence cases being filed against medical professionals and hospitals, the Supreme Court observed that medical negligence was widespread in the number of private hospitals and there was no effective check on it. It had also said that the petitioner would urge neither the Union of India, the MCI nor the State Governments prescribe guidelines for there treatment of the ICU and CCU patients. "That apart, there is no proper care at the stage of operation or post-operational stage," it had noted.
The Apex Court bench had directed the Central Government as well as the erstwhile Medical Council of India (MCI), now the National Medical Commission (NMC), to inform whether any guidelines were prescribed for private hospitals on providing care to patients in the ICU and CCUs.
Consequently, the Union Government set up a committee last year for guidelines for admission to ICUs, CCUs, and palliative care required for non-salvageable patients if removed from the ventilator and criteria for withdrawing treatment.
Then in 2023, the Central Government released ICU guidelines and addressed several issues, including the ICU Admission Criteria and it specifically defined the critically ill patients who should not be admitted to the ICU. Apart from this, these guidelines also clarified the ICU Discharge criteria, further defining the minimum patients monitoring required while awaiting an ICU bed, the minimum stabilisation required before transferring a patient to ICU, and the minimum monitoring required for transferring a critically ill patient (inter-facility transfer to hospital/ICU).
Until September 2024, only eight States and Union Territories (UTs) had so far implemented the Union Government's guidelines issued in 2023. Taking note of the same, the Apex Court bench comprising Justice Sudhanshu Dhulia had issued directions to the remaining States/UTs to inform them by November 4 whether they wished to continue with the Union Government's suggestions or if they wanted changes.
As per the latest media report by Live Law, on August 19, 2025, the Supreme Court had mandated a massive, multi-stakeholder exercise and directed all State Governments and the Union Territory administrations to convene regional conferences involving public and private healthcare experts to draft minimum standardised procedures for critical care. These reports were to be submitted to a central committee for synthesis. Most states failed to act even though the court had set a clear deadline of September 30, 2025, for completing the exercise and October 5, 2025, for submitting reports.
During a hearing of the matter on September 18, 2025, the Court already took note of the central government's compliance along with the absence of any state reports. At that time, the court extended the deadline with a warning of "consequences", while also taking the crucial step of co-opting Dr. Nitish Naik, a senior cardiology professor from AIIMS Delhi, into a three-member expert committee alongside Additional Solicitor General Ms. Aishwarya Bhati and Amicus Curiae Mr. Karan Bharihoke.
Consequently, the hearing before the Apex Court on October 13, 2025, was convened specifically for addressing such continued defiance and the Court was informed that 28 States/UTs have not filed their reports in compliance with its earlier directives.
Disappointed over this, the Court observed, "We are more pained than shocked by the casualness shown by various States, that despite over indulgence shown by the Court with regard to the exercise, the orders of this Court have been taken very lightly by the officers concerned."
"The States were directed to submit their respective reports after conducting the exercise indicated by this Court to the learned Additional Solicitor General, latest by 05.10.2025. However, compliance has not been ensured till date," it further observed.
During the hearing on October 13, the Court was informed that the following States/Union Territories have either not submitted the report or have submitted it beyond the fixed date i.e., 05.10.2025:
i. Arunachal Pradesh
ii. Assam
iii. Chhattisgarh
iv. Goa
v. Gujarat
vi. Himachal Pradesh
vii. Jharkhand
viii. Karnataka
ix. Kerala
x. Madhya Pradesh
xi. Maharashtra
xii. Manipur
xiii. Mizoram
xiv. Odisha
xv. Punjab
xvi. Rajasthan
xvii. Sikkim
xviii. Telangana
xix. Tripura
xx. West Bengal
xxi. Chandigarh
xxii. NCT Delhi
xxiii. Jammu and Kashmir
xxiv. Puducherry
xxv. Lakshadweep
xxvi. Ladakh
xxvii. Andaman and Nicobar
xxviii. Dadra & Nagar Haveli and Daman & Diu
"In our considered opinion, it is now time for the Court to take serious cognizance of such casualness shown by the States/Union Territories," observed the court.
The order further mentioned, "Before parting, the Court requests the Committee to meet at least once a week, if not more frequently, and spend time to deliberate on the material available to them and begin preparing a report, which we understand will require considerable time and effort from the learned members of the three-member Committee."
To view the order, click on the link below:
https://medicaldialogues.in/pdf_upload/supreme-court-icu-304627.pdf
Also Read: ICU, CCU Guidelines: SC Slams Uttrakhand Director General of Health
