Recently, the Supreme Court held that an anaesthetist whose duty hours had ended could not be prosecuted for criminal negligence under Section 304-A of the IPC merely because a staff nurse allegedly committed a procedural error while administering medication after consulting her over the phone. The Court allowed the appeal, quashed the orders refusing discharge, and terminated the criminal proceedings against the Appellant.
Brief facts:
The case arose from the death of a patient who had been admitted to a hospital for piles surgery, where the Appellant was serving as a senior anaesthetist. After the surgery, the patient was shifted to the post-operative ward and later suffered a medical emergency, eventually collapsing. The prosecution alleged that although the Appellant was on call and expected to personally administer post-operative anaesthesia, she instructed the attending nurse to administer the analgesic sensorcaine, following which the patient lost consciousness and collapsed. An FIR was thereafter registered under Section 304-A of the IPC, and a chargesheet was filed under Sections 304-A and 34 of the IPC against the surgeon, the Appellant, and the nurse. The Appellant's petition under Section 482 of the CrPC seeking quashing of the proceedings was dismissed by the High Court, leading to the present appeal.
Contentions of the Appellant:
The Appellant argued that the nurse had given inconsistent versions regarding who instructed her to administer the injection, rendering her statements unreliable. The Counsel further contended that even if telephonic advice had been given, such advice could not amount to a rash or negligent act. The Appellant emphasised that her duty hours had ended, the prescribed medication was medically appropriate, and any alleged failure in administration was attributable to those physically present at the hospital. Reliance was also placed on the consumer forum's findings, which had not attributed liability to the Appellant.
Contentions of the Respondent:
The Respondents maintained that medical negligence stood established through the post-mortem report, departmental inquiry, and expert panel report. According to them, the injection was not properly administered into the epidural space, the nurse lacked sufficient experience for such a specialised procedure, and the Appellant failed to ensure adequate supervision.
Observation of the Court:
The Court observed that the material placed on record did not disclose any act on the part of the Appellant that could attract criminal liability under Section 304-A of the IPC. The Court found that any subsequent lapse in the administration of medication could not automatically be attributed to her, after noticing the fact that the Appellant had completed her duty hours and had left the hospital after ensuring that the patient was stable. The Court observed, “an anaesthetist whose duty hours have concluded cannot be held criminally liable for a subsequent procedural error committed by a staff nurse.”
The Bench further held that even if the prosecution's version was accepted in its entirety, the allegation that the Appellant advised administration of a painkiller over the phone did not amount to criminal negligence. The Court held, “Even if the prosecution’s case is taken at face value that the Appellant suggested a painkiller over the phone, such an act constitutes standard medical advice for post-operative pain, not gross criminal recklessness.” The Court further observed that the alleged failure of the nurse in administering the injection properly may, at best, give rise to civil consequences, but could not satisfy the threshold of criminal culpability required under Section 304-A of the IPC. The Court observed, “The failure of the nurse to accurately locate the epidural space might represent a deficiency in service (civil liability), but it fundamentally lacks the gross culpability or mens rea required to invoke Section 304-A IPC.”
The Court also found that there was no proximate connection between the Appellant's conduct and the patient's death. Emphasising the settled principles governing criminal negligence, the Court held, “Criminal liability under Section 304-A IPC necessitates a direct, proximate nexus between the negligent act and the death (causa causans).” Noting that the deceased suffered from an undisclosed cardiac condition and that the immediate cause of death was acute coronary insufficiency, the Court observed, “Fastening criminal liability on an off-duty anaesthetist for an underlying, undisclosed cardiac condition stretches the legal doctrine of proximate cause beyond permissible limits.”
The decision of the Court:
The Apex Court allowed the appeal, quashed the High Court's order, and held that continuation of criminal proceedings against the Appellant was unsustainable. Consequently, the criminal case pending before the Judicial Magistrate First Class-I, Kannur, was quashed and the Appellant was discharged from all offences alleged against her.
Case Title: Supriya Kumari M.C. Vs. State of Kerala & Ors.
Case No.: Special Leave Petition (Crl.) No. 124 of 2025
Coram: Hon'ble Mr. Justice Pankaj Mithal, Hon'ble Mr. Justice Prasanna B. Varale
Advocate for the Petitioner: Sr. Adv. R. Basant, AOR Divyanshu Sahay, Adv. Kavinesh, Adv. Akshay Sahay, Adv. Shradha Narayan
Advocate for the Respondent: AOR Harshad V. Hameed, AOR Ravi Prakash Adv. Dileep Poolakkot, Adv. Ashly Harshad, Adv. Rashi Agnihotry, Adv. Anukirat Singh Baweja, Adv. Muhammed Siddick, Adv. Mahabir Singh
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