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[Cites 7, Cited by 2]

Gujarat High Court

Surendrabhai Ramjibhai Patel & vs State Of Gujarat & 3 on 24 March, 2017

Author: Biren Vaishnav

Bench: Biren Vaishnav

                R/SCR.A/3469/2013                                              CAV JUDGMENT



                     IN THE HIGH COURT OF GUJARAT AT AHMEDABAD

              SPECIAL CRIMINAL APPLICATION (QUASHING) NO. 3469 of 2013



         FOR APPROVAL AND SIGNATURE:


         HONOURABLE MR.JUSTICE BIREN VAISHNAV

         ==========================================================

         1     Whether Reporters of Local Papers may be allowed
               to see the judgment ?

         2     To be referred to the Reporter or not ?

         3     Whether their Lordships wish to see the fair copy of
               the judgment ?

         4     Whether this case involves a substantial question of
               law as to the interpretation of the Constitution of
               India or any order made thereunder ?

         ==========================================================
                     SURENDRABHAI RAMJIBHAI PATEL & 1....Applicant(s)
                                       Versus
                         STATE OF GUJARAT & 3....Respondent(s)
         ==========================================================
         Appearance:
         MS. YASHODHARA PANDYA, ADVOCATE FOR MR RAJESH K SHAH,
         ADVOCATE for the Applicant(s) No. 1 - 2
         MR SUDHANSHU S PATEL, ADVOCATE for the Respondent(s) No. 4
         MR. HIMANSHU K PATEL, ADDITIONAL PUBLIC PROSECUTOR for the
         Respondent(s) No. 1
         RULE SERVED BY DS for the Respondent(s) No. 2 - 3
         ==========================================================
             CORAM: HONOURABLE MR.JUSTICE BIREN VAISHNAV

                                    Date :      24 /03/2017
                                      CAV JUDGMENT

1 Petitioners of this petition are Doctor and Nurse  Page 1 of 16 HC-NIC Page 1 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT respectively,   who   have   approached   this   Court   under  Section 482 of the Code of Criminal Procedure with the  prayer to quash and set aside the FIR bearing No. C.R  No. I­ 119 of 2009 registered with the Songadh Police  Station, District: Tapi, at Vyara under Section 304 A  read   with   Section   114   of   the   Indian   Penal   Code.  Respondent   No.4   Rekhaben,   daughter   of   Mohanbhai  Shantilal Gamit sister of deceased Sunita registered  the aforesaid First Information Report on 01.12.2009.  2 According   to   the   complainant,   who   is   respondent  No.4   herein,   her   sister   Sunita   was   married   to   one  Rupesh   Rupsingh   Gamit.   She   conceived   from   the  marriage. On 13.11.2009, according to the complainant,  her   sister   Sunita   complained   of   labour   pains,   and  therefore,   her   father   and   Rupesh   called   for   an   108  ambulance. At 4 O'clock in the evening, she along with  her   parents   and   one   Deepikaben   went   to   the   Songadh  Government Dispensary for the delivery of the child of  Sunitaben. According to the complainant at six in the  evening, Sunita delivered a normal baby. It is a case  of the complainant that, after the post delivery care  she found that it was a case of Intra Uterine Inverse  Page 2 of 16 HC-NIC Page 2 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT inasmuch   as   the   uterus   came   out.   The   complainant's  case   is   that,   it   was   the   staff   nurse   who   was  responsible for this condition. The complaint further  goes   to   recite   that   the   doctor   concerned   at   the  Songadh   Government   Hospital   called   for   an   ambulance  and   referred   Sunitaben   to   the   Government   Bardoli  Hospital, where Sunitaben was administered intravenous  drugs and subsequently shifted to the Civil Hospital  at   Surat.   The   complainant   further   states   that   the  doctors at Surat opined that there were slim chances  of   her   survival.   Sunita   died   soon   thereafter.  According to the complainant, while the doctor and the  nurse   had   undertaken   the   delivery   procedure   of   the  child,   the   uterus   during   the   post   delivery   medical  attention came out, which caused severe bleeding, as a  result   of   which   Sunita   succumbed   to   that   condition.  Sunita's   sister   Rekha   therefore   lodged   a   complaint  against   the   doctor   and   the   nurse,   the   petitioners  herein under Section 304­A of the IPC and Section 114  of   the   Indian   Penal   Code.     According   to   the  complainant,   Sunita's   death   occurred   due   to   medical  negligence and therefore doctor and nurse were liable  and   therefore   she   sought   their   prosecution   under  Page 3 of 16 HC-NIC Page 3 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT provisions   of   Section   304­A   and   114   of   the   Indian  Penal Code as a result of their negligent act that her  sister   Sunita   suffered   inversion   of   uterus   and   the  resultant death therefrom. 

3 Ms   Yashodhara   Pandya,   learned   advocate   for   Mr.  Rajesh   K   Shah   for   the   petitioner   has   vehemently  contended that the doctor and the nurse cannot be held  responsible   for   medical   negligence   for   the   death   of  respondent No.4­ original complainant's sister. It is  the contention of the learned advocate that they were  in no manner responsible for the incident of, what is  in medical terms known as "Intra Uterine Inversion" as  in the history that was recorded on admission of the  patient it was found that two mid­wives Chhagniben and  Vestiben, who had in order to facilitate delivery of a  normal   child   had   applied   "fundal   pressure"   on   the  patient's stomach with oil massage. Having failed to  induce   delivery,   the   patient   was   shifted   to   the  hospital  under  the   care  of  the   applicant   doctor  and  the   nurse   respectively.   According   to   the   medical  condition then, it was found that the patient had been  administered massage with the oil and the head of the  Page 4 of 16 HC-NIC Page 4 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT unborn   child   was   in   the   Cervical   Canal   in   the  peronium. In short, it was the case of the applicant­ petitioner before this court, that the doctor and the  nurse respectively are in no way responsible for what  is in medical terms called Intra Uterine Inversion and  it was only because of the untrained mid­wives who had  applied and massaged oil to induce delivery that the  consequential   "fundal   pressure"   had   caused   such   a  medical condition. 

4 Learned advocate Ms. Pandya has taken me through  the chargesheet papers which have been annexed to the  petition.   The   statement   of   doctor   Surendra   Rambhai  Patel the applicant no.1 was recorded on 09.04.2010.  According   to   the   doctor,   when   he   was   at   the  dispensary, Sunitaben the patient arrived from village  Khanjar   complaining   of   stomach   pain.   She   was  accompanied   by   two   mid­wives.   She   was   immediately  taken to the labour room together with the staff nurse  and   two   mid­wives   that   had   accompanied.   On   making  inquiries,   the   patient   categorically   told   him   that,  since she already had undergone labour pains earlier,  in order to induce delivery her mother had called two  Page 5 of 16 HC-NIC Page 5 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT untrained mid­wives so as to facilitate such delivery.  She   was   subjected   to   oil   massage   on   her   stomach   so  that   a   normal   delivery   can   be   facilitated.   Having  failed to do so and the pain having become unbearable,  she was brought to the present dispensary. The police  also recorded statement of one Ramilaben and one aaya  working at the dispensary. She also in her statement  so recorded on 09.04.2010, supported the statement of  the   doctor   that   Sunitaben   was   taken   to   the   labour  room. Sunitaben informed doctor of the fact that two  mid­wives   who   were   accompanying   her   had   tried   to  induce normal delivery by massaging her stomach with  oil, and having failed to do so and the pain becoming  unbearable,   she   was   shifted   to   the   dispensary.   The  doctor examined her and found that the unborn child's  head was in the Cervical Canal (birth canal). Having  found that she needed immediate medical attention, she  was   taken   care   of.   The   baby   was   delivered   and   then  what   occurred   was   in   medical   terms   known   as   Intra  Uterine   Inversion,   which   is   a  case   where   the  uterus  comes   out.   Having   been   faced   with   such   medical  condition, it has come out from the statement of the  doctor,   that   she   was   thereafter   shifted   to   a  Page 6 of 16 HC-NIC Page 6 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT government   hospital,   which   had   better   facilities   as  repositioning of uterus was not possible at the local  dispensary.   Sunitaben   died,   according   to   the   post  mortem   report,  due   to   uterine  inversion   and   what   is  called post partum haemorrhage. The post mortem report  at page 136 and the final cause of death at page 137  of the paper book elicit this information.  5 Mr.   Sudhanshu   Patel   ,   appearing   for   respondent  No.4 original complainant, has also taken me to paper  book   and   drawn   my   attention   to   the   report   of   the  Department of Forensic and Toxicology and pointed out  that   the   death   occurred   due   to   the   Intra   Uterine  Inversion and  prima facie  such death occurred due to  medical negligence of the doctor. This, according to  Mr. Sudhanshu Patel, makes it apparent  that when such  opinion of the department is read with the final cause  of death certificate, it leaves no room of doubt to  substantiate   the   complainant's   grievance   that   the  death occurred due to medical negligence of the doctor  and   the   nurse   respectively.   The   Court,   therefore,  should not entertain the petition. 

Page 7 of 16 HC-NIC Page 7 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT 6 As   against   that,   as   pointed   out   by   Ms.   Pandya,  learned advocate for the petitioner, the fact that the  two mid­wives had applied "fundal pressure", the cause  of   death   of   Intra   Uterine   Inversion   as   per   the  statements   of   the   doctor   and   the   aaya   respectively  were   a   clear   pointer   to   the   fact   that   there   was   no  negligence   on   the   part   of   the   doctor   and   the   nurse  respectively.   She   has   invited   my   attention   to   the  decision   in   the   case   of  Jacob   Mathew   vs.   State   of   Punjab and another  reported in (2005) 6 SCC pg 1  to  contend that in view of the decision of the Supreme  Court in the aforesaid judgement, the doctor and the  nurse   respectively   who   are   professionals   cannot   be  fastened   with   "negligence"   under   the   criminal   law  because the degree of negligence was not high enough  or infact there wasn't any negligence on their part so  as to foist charges under Sections 304­A and 114 of  the Indian Penal Code. She has also sought to rely on  judgments of the Supreme Court in the case of  Martin   F D'souza vs. Mohd. Ishfaq  reported in (2009) 3 SCC   pg   1  and   in   the   case   of  Kusum   Sharma   and   ors.   vs.   Batra  Hospital  and Medical  Research  Centre  and  ors.  reported   in   (2010)   3   SCC   483  to   contend   that   there  Page 8 of 16 HC-NIC Page 8 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT cannot   be   indiscriminate   prosecution   of   medical  professionals   for   criminal   negligence,   as   has   been  held   by   the  judgments   referred   to   herein   above.  She  has specifically invited my attention to  the decision  in   the   case   of  Jacob   Mathew   (supra)  wherein   the  Hon'ble Supreme Court has considered various decisions  particularly in the case of  Bolam v. Friern Hospital   Management   Committee.  According   to   her,   there   could  be   no   negligence   attributed   to   the   doctor   and   the  nurse respectively as long as it was found that the  procedure   that   was   adopted   was   one   which   was  acceptable   to   medical   science.   According   to   Ms.  Pandya,   the  Supreme   Court   in   that   judgment   has   also  held that, no case is made out by the complainant to  show   negligence   at   the   hands   of   the   applicant.  Attention   is   drawn   to   paragraph   48   of   the  judgment,  which according to her makes out a case of quashing of  the complaint. It will be in the fitness of things to  reproduce the conclusions as laid down in paragraph 48  of Jacob Mathews case, which reads as under:

"48 We sum up our conclusions as under:
(1) Negligence   is   the   breach   of   a   duty  caused by omission to do something  which a  reasonable   man   guided   by   those  considerations which ordinarily regulate the  Page 9 of 16 HC-NIC Page 9 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT conduct of human affairs would do, or doing  something which a prudent and reasonable man  would   not   do.   The   definition   of   negligence   as   given   in   Law   of   Torts,   Ratanlal   &  Dhirajlal   (edited   by   Justice   G   P   Singh),  referred   to   hereinabove,   holds   good.  Negligence becomes actionable on account of  injury   resulting   from   the   act   or   omission  amounting to negligence attributable to the  person   sued.   The   essential   components   of  negligence   are   three:   "duty",   "breach"   and   "resulting damage".

(2) Negligence   in   the   context   of   the  medical   profession   necessarily   calls   for   a  treatment   with   a   difference.   To   infer   rashness   or   negligence   on   the   part   of   a  professional,   in   particular   a   doctor,  additional   considerations   apply.   A   case   of  occupational   negligence   is   different   from  one   of   professional   negligence.   A   simple  lack   of   care,   an   error   of   judgment   or   an  accident, is not proof of negligence on the  part of a medical professional. So long as a   doctor follows a practice acceptable to the  medical profession of that day, he cannot be   held liable for negligence merely because a  better   alternative   course   or   method   of  treatment   was   also   available   or   simply  because a more skilled doctor would not have   chosen to follow or resort to that practice  or   procedure   which   the   accused   followed.  When   it   comes   to   the   failure   of   taking   precautions, what has to be seen is whether  those   precautions   were   taken   which   the  ordinary experience  of men has found to be  sufficient;   a   failure   to   use   special   or  extraordinary   precautions   which   might   have  prevented the particular happening cannot be  the   standard   for   judging   the   alleged  negligence.   So   also,   the   standard   of   care,   while assessing the practice as adopted, is  judged   in   the   light   of   knowledge   available   at the time of the incident, and not at the   date of trial. Similarly, when the charge of   negligence arises out of failure to use some   particular equipment, the charge would fail  Page 10 of 16 HC-NIC Page 10 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT if the equipment was not generally available  at that particular time (that is the time of   the incident)  at which  it should have been  used.

(3) A   professional   may   be   held   liable   for  negligence   on   one   of   the   two   findings: 

either he was not possessed of the requisite   skill which he professed to have possessed,  or,   he   did   not   exercise,   with   reasonable  competence   in   the   given   case,   the   skill  which   he   did   possess.   The   standard   to   be  applied   for   judging,   whether   the   person  charged has been negligent or not, would be  that   of   an   ordinary   competent   person  exercising   ordinary   skill   in   that  profession.   It   is   not   possible   for   every  professional to possess the highest level of   expertise or skills in that branch which he  practices. A highly skilled professional may  be   possessed   of   better   qualities,   but   that   cannot   be   made   the   basis   or   the   yardstick  for   judging   the   performance   of   the   professional proceeded against on indictment  of negligence. 
(4) The   test   for   determining   medical  negligence as  laid down in Bolam case, WLR  at p. 586 holds good in its applicability in   India. 
(5) The   jurisprudential   concept   of  negligence   differs   in   civil   and   criminal  law. What may be negligence in civil law may   not   necessarily   be   negligence   in   criminal  law. For negligence to amount to an offence,   the   element   of   mens   rea   must   be   shown   to  exist.   For   an   act   to   amount   to   criminal  negligence, the degree of negligence should  be much higher i.e. gross or of a very high   degree.   Negligence   which   is   neither   gross  nor of a higher degree may provide a ground  for action in civil law but cannot form the  basis for prosecution.
(6) The   word   "gross"   has   not   been   used   in  Section 304­A IPC, yet it is settled that in   criminal law negligence or recklessness, to  be so held, must be of such a high degree as  to   be   "gross".   The   expression   "rash   or  Page 11 of 16 HC-NIC Page 11 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT negligent act" as occurring in Section 304­A  IPC has to be read as qualified by the word   "grossly".
(7) To prosecute a medical professional for  negligence   under   criminal   law   it   must   be  shown   that   the   accused   did   something   or  failed   to   do   something   which   in   the   given  facts   and   circumstances   no   medical  professional   in   his   ordinary   senses   and  prudence   would   have   done   or   failed   to   do. 

The   hazard   taken   by   the   accused   doctor  should be of such a nature that the injury  which resulted was most likely imminen. 

(8) Res   ipsa   loquitur   is   only   a   rule   of   evidence and operates in the domain of civil   law, specially in cases of torts and helps  in determining the onus of proof in actions  relating to negligence. It cannot be pressed   in domain of criminal law. Res ipsa loquitur   has,   if   at   all,   a   limited   application   in  trial on a charge of criminal negligence."   7 According   to   Mr.   Sudhanshu   Patel,   learned  advocate   for   respondent   No.4,   in   view   of   the  Toxicology Report and the opinion of the doctor, who  carried out the post mortem, when once prima facie the  investigation   attributed   negligence   to   the   doctor,  guidelines   summed   up   in   the   case   of  Jacob   Mathew  (supra)  could not be  of any help. The Investigation  Report was clearly a pointer that the doctor and the  nurse   were   negligent   in   attending   the  patient.  Therefore, the cause of death was a direct factor as a  result of such negligence on the part of the doctor  and   therefore   the  ingredients  of  Section   304  part   A  Page 12 of 16 HC-NIC Page 12 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT were attracted. 

8 This Court in exercise of its power under Section  482   is   conscious   of   the   fact   that   the   powers   of  section 482 have to be sparingly used. In the event,  when ,  prima facie  the investigation shows a hint of  culpability   of   the   offenders,   this   court   should  withdraw its self from exercising power under Section  482 of the Cr.P.C. 

9 However,   in   the   facts   of   the   present   case,  conscious of this limitations this court considers it  fit to hold otherwise for the following reasons:

A As  is  evident   from   the   history   recorded   by  doctor,   which   is   evident   from   statement   dated  09.04.2010, that when the patient was brought to the  dispensary, in the condition that she was, the history  recorded   evidently   shows   that   in   order   to   induce  normal delivery, the lady had been subjected to what  is   in   medical   terms   called   "fundal   pressure"   by  massaging her stomach with oil by two untrained mid­ wives. 

B It is also evident from the statement of the  Page 13 of 16 HC-NIC Page 13 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT doctor and aaya of the dispensary that the head of the  unborn   child   was   in   the   "Cervical   Canal"   (birth  canal). 

C Medical   research   has   shown   that   uterine  funal pressure is traditionally applied by "daayas and  some health workers" in the belief that it helps to  increase expulsive efforts in labour. This is evident  from   an   article   of   a   consultant   anaesthetist,   which  speaks   about   the   age   old   practice   of   uterine   funal  pressure   in   labour.   On   reading   the   paragraph   of  introduction   of   that   article,   discussion   and  conclusions and corelating them with the statement of  doctor and the aaya in the facts of the present case,  it   can   be   reasonably   believed   that,   the   act   of   the  mid­wives who induced labour and increased expulsive  efforts in labour contributed to the medical condition  of the patient.

D Even,   in   a   medical   Journal   of   Perinatology  where child birth practices were reviewed, on reading  the   introduction,   it   becomes   evident   that   India  suffers largest share of maternal death, where it is  worthwhile to note the information that they gathered  that   an   important   reason   for   women   preferring   home  Page 14 of 16 HC-NIC Page 14 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT deliveries   was   that   the   TBA   'touches'   the   woman   or  'uses her hands'. This meant that she uses a massage  like   action   to   apply   compressive   pressure   on   the  woman's   abdomen,   to   help   her   deliver.   By   contrast,  hospital   staff­   nurses   and   doctors   -   were   seen   as  having   a   'hands­off'   approach­   they   merely   exhorted  women   to   'apply   strength'   (bear   down)   while  administering   'heat   injections'   or   'bottles'  (intravenous   drips).   Evidently,   therefore,   in  accordance with the prevalent practice the patient in  question,   i.e.   respondent   No.   4's   sister   received  treatment at the hands of untrained mid­wives so as to  expedite   the   expulsive   efforts,   which   can   safely   be  presumed  to  have   led  to  the   medical  condition   which  occurred post birth.    

E   Keeping   the   above   parameters   in   view,   and   in  light of the fact that evidently efforts prior to the  patient's   admission   at   the   dispensary   was   made   by  untrained mid­wives, co­relating them to the medical  research negligence on the part of the doctor and the  nurse   is   evidently   not   possible.   Merely   because   the  department   of   Forensic   and   Toxicology   and   the   final  cause   of   death   certificate   attribute   post   partum  Page 15 of 16 HC-NIC Page 15 of 16 Created On Tue Aug 15 07:39:39 IST 2017 R/SCR.A/3469/2013 CAV JUDGMENT haemmorrhage as the cause of death, which occurred due  to Intra Uterine Inversion the doctor and the nurse ­  the applicants/petitioners herein in the facts of the  case and looking to the law laid down in the Supreme  Court   as   referred   herein   in   the   cases   of  1)   Jacob   Mathew vs. State of Punjab and another , 2) Martin F   D'souza   vs.   Mohd.   Ishfaq   and   3)   Kusum   Sharma   and   ors. vs. Batra Hospital  and Medical  Research  Centre   and ors.,  cannot be held to be negligent. Therefore,  the   petitioners   cannot   as   medical   professionals   be  faced  to  undergo   exposure   to   the  charge   of   criminal  negligence,   for   which   they   were   not   responsible.   In  the   result,   the   petition   succeeds.     Thus,   the   FIR  bearing No. C.R No. I­ 119 of 2009 registered with the  Songadh Police Station, District: Tapi, at Vyara for  the offences punishable under Section 304­A read with  Section   114   of   the   Indian   Penal   Code,   is   hereby  quashed and set aside. Rule made absolute. 

(BIREN VAISHNAV, J.) Bimal Page 16 of 16 HC-NIC Page 16 of 16 Created On Tue Aug 15 07:39:39 IST 2017