Dr. Suresh Gupta v. Govt. of NCT of Delhi & Anr.
Authored By- Anushka Mhatre
Keywords: criminal liability, criminal negligence, gross negligence, medical report, asphyxia.
Citation: AIR 2004 SC 4091.
Case No.: Appeal(crl.) 778 of 2004.
Petitioner: Dr. Suresh Gupta
Respondent: Govt. of NCT of Delhi & Anr.
Bench: Justice Y. K. Sabharwal, Justice D. M. Dharmadhikari.
Date of Judgement: 04/08/2004.
This article critically analyses the case of Dr. Suresh Gupta v. Govt. of NCT of Delhi & Anr.[i]. The case deals with the criminal liability of doctors in case of medical negligence. In this case, a young man passed away during the medical procedure for nasal deformity. The Supreme Court held in this case that mere lack of necessary care, attention, or skill would be insufficient to hold a doctor criminally liable for negligence under Section 304A of the IPC even though it might create civil liability.
The term ‘medical negligence’ refers to wrongful actions or omissions by medical professionals while treating the patients. It is established that where a patient dies due to the negligent medical treatment of the doctor, the doctor can be made liable under civil law for paying compensation and if the degree of negligence is so gross and his act was reckless as to endanger the life of the patient, he would also be made criminally liable for the offence under Section 304A of IPC. In the present case, the patient was a young man with no history of any heart disease. The operation to be performed for nasal deformity and it was not so complicated. The patient passed away at the time of operation. There was a lack of skill and care on behalf of the surgeon. For this act of negligence, he can be held liable under civil law but cannot be held criminally liable as the carelessness of the doctor was not so reckless or grossly negligent. It was held in the case that; the act of the doctor should be of very high degree of recklessness or grossly negligent. Otherwise, the doctor will not be liable under criminal law.
Concerned Provisions of law
1. Section 304A of IPC: Causing death by Negligence.
2. Section 80 of IPC: Accident in doing a lawful act.
3. Section 88 of IPC: Act not intended to cause death, done by consent in good faith for a person’s benefit.
1. The appellant is a doctor who is accused under Section 304A of the IPC for causing the death of his patient on 18/4/1994 but the post-mortem was conducted on 21.4.1994.
2. The patient was operated by him for removing his nasal deformity. The doctor was accompanied by an Anesthetist who was assisting him in the operation was also made co-accused, but he died pending the trial, and thus, the proceedings stand abated against him.
3. The post-mortem report stated that the death was due to the "blockage of respiratory passage by aspirated blood consequent upon the surgically incised margin of the nasal septum."
4. The District Magistrate held him criminally liable under Section 304A of IPC citing that that death was due to the complication arising out of the operation.
5. As the Magistrate decided to proceed with the trial, the doctor approached the High Court under Section 482 of the Code of Criminal Procedure. The High Court upheld the orders of the Magistrate and refused to quash the criminal proceedings.
Whether or not the surgeon is criminally liable for the offence under Section 304A of the IPC?
Opinion of Medical Experts
After the perusal of all the documents produced before the Committee, they opined that the death occurred due to sudden cardiac arrest of which the direct reason cannot be decided. The Cardiac Arrest could be due to hypotension due head-up-position, adverse drug reaction, or due to hypoxia death due to asphyxia resulting from blockage of air passage secondary to antemortem aspiration of blood from the wound is not likely in the presence of a cuffed endotracheal tube of a proper size which was introduced before the operation and remained in the position till the patient was declared dead in Sir Ganga Ram Hospital. The presence of fluid and clotted blood in the respiratory passage, as mentioned in the post-mortem report, due to trickling of decomposition bloody fluid and some clot present in the nostril from the site of incision in the nose, cannot be ruled out after the tube is taken out. One of the medical experts opined that both anesthetics and the surgeon immediately after noticing the cardiac arrest started resuscitative measures in time to save the patient's life. With all good intentions, they shifted the patient under manual ventilation to Ganga Ram Hospital's ICU.[ii]
The Judges held that after examining all the medical papers accompanying the complaint, there was no recklessness or gross negligence made by the doctor to compel him to face the trial under Section 304A of the IPC. For holding a surgeon criminally liable, the standard of negligence must be very high which can be described as "gross negligence" or recklessness". Mere lack of necessary care, attention, and skill will not be sufficient to impose criminal liability. A careless act of a doctor can be termed as 'criminal' only when the doctor exhibits a gross lack of competence and negligence. If a patient dies due to an error of judgment of a doctor, the doctor can't be held liable under criminal law. Some amount of want of adequate care and caution might create civil liability but would not suffice to hold him criminally liable. If the courts were to impose criminal liability on hospitals and doctors for everything that goes wrong, then doctors would be more worried about their own safety than giving the best treatment to their patients. For the act of negligence of the doctor in the present case, he may be liable in tort, but his carelessness cannot be described to be grossly negligent as to make him criminally liable. Only when gross negligence in which it can be proved that the doctors were totally apathetic towards the patient, then the doctors would be punishable under criminal law. Thus, the bench held that the surgeon is not liable under Section 304A of the IPC. The appeal was allowed and the impugned orders of the Magistrate and of the High Court were set aside.
The degree of negligence plays a significant role in deciding the civil or criminal liability of doctors. To hold a person guilty of negligence, the element of mens rea must be shown to exist. The amount of negligence must be ‘gross’ or of a very high degree. It was held by Sir Lawrence Jenkins in Emperor v. Omkar Rampratap[iii]that to impose criminal liability under Section 304A, the death must be caused due to the direct rash and negligent act of the accused. There is no mathematical formula to calculate the degree of negligence and it will vary from one case to another in medical cases. In the present case, though the patient had no medical history of heart ailments, but the carelessness of the doctor cannot be considered as reckless and grossly negligent to hold him criminally liable. For this act of negligence, he may be liable in tort but his carelessness or want of due attention and skill cannot be considered to be so reckless or grossly negligent as to make him criminally liable.
To impose civil or criminal liability of a doctor causing the death of his patient, it is difficult to decide the degree of carelessness and negligence alleged on the part of the doctor. If the doctors were held criminally liable for every negligent act, the doctors would always first prefer to protect themselves and then the patients. The patients would lose faith in doctors. This is a landmark judgment in the medical field laying down standards with respect to criminal liability for medical negligence.
[i] Dr. Suresh Gupta v. Govt. of NCT of Delhi &Anr, AIR 2004 SC 4091. [ii]Ibid. [iii] Emperor v. Omkar Rampratap, 4 Bom LR 679. References