Indian Penal Code, 1860 — Section 304-A
Criminal negligence — Degree of negligence — “Gross” negligence mandatory
For negligence to amount to an offence under Section 304-A IPC, the degree of negligence must be gross or of a very high degree.
Simple lack of care, error of judgment or accident is insufficient to attract criminal liability.
Paras: 48–52, 59–60, 65–67
Criminal law — Mens rea — Essential requirement
In criminal negligence, the element of mens rea cannot be excluded.
The accused must have acted with such recklessness or indifference to consequences as to amount to a crime against the State.
Paras: 44–47, 58–60
Civil negligence and criminal negligence — Distinction
Negligence actionable in tort is distinct from negligence punishable as a crime.
What may constitute negligence in civil law does not necessarily constitute criminal negligence.
Paras: 42–45, 58–61
Section 304-A — Rash or negligent act — Proximate cause
The rash or negligent act must be the direct, proximate and efficient cause of death, and not merely a remote or indirect cause.
Paras: 63–64
Medical Negligence
Medical professionals — Standard of care
A medical professional is required to exercise:
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reasonable degree of skill and knowledge; and
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reasonable degree of care.
He does not assure a cure nor guarantee success.
Paras: 68–71
Bolam test — Applicability in India
The test laid down in Bolam v. Friern Hospital Management Committee (1957) governs determination of medical negligence in India.
A doctor is not negligent if he has acted in accordance with a practice accepted as proper by a responsible body of medical professionals.
Paras: 72–75
Professional negligence — Two circumstances attracting liability
A medical professional may be held negligent if:
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he lacked the requisite skill which he professed to possess; or
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he failed to exercise reasonable competence in applying that skill.
Paras: 71–72
Error of judgment — Not negligence per se
A mere error of judgment or failure of treatment does not amount to negligence.
Paras: 76–79
Deviation from normal practice — Not conclusive
Deviation from standard practice is not negligence unless the course adopted is one which no ordinary competent professional would have taken.
Paras: 74–77
Res ipsa loquitur — Limited application
The doctrine of res ipsa loquitur is a rule of evidence applicable primarily in civil cases.
It has limited or no application for proving criminal negligence under Section 304-A IPC.
Paras: 80–83
Criminal prosecution of doctors
Requirement of expert medical opinion
Before proceeding against a doctor for criminal negligence, an independent and competent medical opinion applying the Bolam test is necessary.
Paras: 92–93
Arrest of doctors — Restriction
A doctor accused of negligence should not be arrested in a routine manner.
Arrest is permissible only where:
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it is necessary for investigation; or
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there is likelihood of absconding; or
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custodial interrogation is required.
Paras: 94–95
Precedents Considered
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Dr. Suresh Gupta v. Govt. of NCT of Delhi, (2004) 6 SCC 422 — approved
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Kurban Hussein Mohammedali Rangawalla v. State of Maharashtra, (1965) 2 SCR 622 — followed
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Suleman Rehiman Mulani v. State of Maharashtra, (1968) 2 SCR 515 — followed
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Syad Akbar v. State of Karnataka, (1980) 1 SCC 30 — followed
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John Oni Akerele v. King, AIR 1943 PC 72 — approved
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Bolam v. Friern Hospital Management Committee, [1957] 1 WLR 582 — adopted
ANALYSIS OF FACTS
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Patient suffering from terminal cancer was admitted to hospital at relatives’ insistence.
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Patient developed respiratory distress at night.
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Oxygen cylinder attached was found empty.
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No alternative cylinder was immediately available.
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Patient died before oxygen supply could be restored.
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FIR was lodged alleging carelessness of doctors and nurses.
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Doctors were charge-sheeted under Section 304-A read with Section 34 IPC.
ANALYSIS OF LAW
1. Nature of Negligence in Criminal Law
The Court undertook an exhaustive review of:
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English law
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Privy Council decisions
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Indian Supreme Court jurisprudence
and reiterated that:
criminal negligence requires a very high degree of negligence.
2. Degree test — “Gross negligence”
Although the word “gross” does not appear in Section 304-A IPC, judicial interpretation has consistently held that:
rashness or negligence under Section 304-A must be read as gross rashness or gross negligence.
3. Protection of medical professionals
The Court emphasized that:
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Medicine is an uncertain science.
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Professionals frequently act under emergencies.
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Fear of criminal prosecution would deter doctors from life-saving interventions.
Hence, indiscriminate prosecution would be counter-productive to society.
4. Applicability of Bolam test
The Court affirmed that:
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Where multiple acceptable medical practices exist, choosing one cannot constitute negligence.
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Courts cannot substitute their views for medical judgment.
5. Reaffirmation of earlier Section 304-A jurisprudence
The Court expressly reaffirmed:
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Kurban Hussein Rangawalla (1965)
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Suleman Mulani (1968)
holding that:
death must be the direct and proximate consequence of the accused’s act.
RATIO DECIDENDI
1. Criminal negligence under Section 304-A IPC requires gross negligence
Negligence to be punishable under criminal law must be gross or of a very high degree; mere error of judgment, accident or lack of care sufficient for civil liability does not constitute criminal negligence.
2. Medical professionals are liable only where conduct is such that no competent doctor would have acted similarly
A doctor can be prosecuted criminally only where his act or omission is so reckless or grossly negligent that no medical professional of ordinary prudence would have done or omitted to do such act.
3. Bolam test governs criminal prosecution of doctors
Medical negligence must be assessed in light of the medical knowledge available at the time and by applying the Bolam test.
GUIDELINES LAID DOWN (BINDING LAW)
Before prosecuting doctors under Section 304-A IPC:
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Credible expert medical opinion mandatory
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Opinion must apply Bolam test
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Routine arrest prohibited
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Prosecution only where gross negligence is prima facie made out
FINAL ORDER
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Criminal proceedings under Section 304-A/34 IPC quashed
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Appeals allowed
CONSTITUTIONAL & JURISPRUDENTIAL SIGNIFICANCE
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Landmark authority on criminal medical negligence
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Definitive interpretation of Section 304-A IPC
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Harmonises Kurban Hussein (1965) → Suleman Mulani (1968) → Jacob Mathew (2005)
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Binding precedent protecting medical professionals from frivolous prosecution
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Continues to govern criminal negligence jurisprudence in India
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