Doctors Won't Presumably Commit 'Medical Negligence' As It Can Ruin Their Professional And Economic Stability: Rajasthan HC Quashes FIR

While quashing an FIR against private doctors booked for negligently mistreating a patient pursuant to which she passed away, the Rajasthan High Court observed that it would be wrong to assume that a doctor or institution shall deliberately risk its reputation by engaging in rash and negligent medical practices.

In doing so the court observed that the "risk of professional ruin, economic decline, and eventual institutional collapse" are factors that act as a natural deterrent against any wilful lapse in the standard of care on the doctors/medical institutions part.

The Court was hearing petitions moved by four doctors for quashing of an FIR under BNS Section 105 (culpable homicide not amounting to murder) wherein the complainant alleged "grave medical negligence" in her treatment including omission of pre-operative tests, delayed critical diagnostics and improper post-operative care, which allegedly resulted in death of complainant's daughter-in-law, who was hospitalised to a hospital in Jodhpur for minor uterine fibroid surgery.

Doctors guided by clinical interest of patient and by reputational constraints

Justice Farjand Ali in his order said:

"this Court is also mindful of the fact that the reputation and functional credibility of private medical institutions are inherently tied to their standards of care and patient outcomes. In the modern healthcare ecosystem, no private hospital or its professional staff can reasonably be presumed to operate with a wilful disregard for human life, especially when such conduct would directly undermine their institutional standing, public trust, and economic viability. A medical practitioner operating within a private setup is guided not merely by the clinical interest of the patient but also by the ethical and reputational constraints of the institution under whose aegis he functions. It must further be appreciated that a single adverse outcome, if even remotely attributable to a negligent act, has the potential to cause irreparable damage to the professional standing of both the doctor and the hospital"

The court observed that in the health care sector where public confidence serves as the cornerstone of survival, the mere perception of substandard care can derail years of "painstakingly built credibility". It observed that private healthcare institutions operate not just as treatment facilities but as "trust-based service entities" which are heavily reliant on "goodwill, word-of-mouth, and community validation".

Risk of doctor's professional ruin acts a natural deterrent against wilful lapse in care

"The inflow of patients, which sustains the operational and financial viability of such institutions, is directly proportional to the public's perception of their clinical integrity. Consequently, even from a purely pragmatic or commercial standpoint, it defies logic to assume that a doctor or institution would deliberately risk such reputational capital  by engaging in rash or negligent medical practices. The risk of professional ruin, economic decline, and eventual institutional collapse acts as a natural deterrent against any willful lapse in the standard of care. Indeed, the very business model of private healthcare is predicated on the maintenance of —professional goodwill and ethical reliability. The erosion of this trust, through real or perceived negligence, would cause a rapid attrition of patient inflow, leading not only to financial instability but to the eventual dismantling of the entire clinical establishment. Thus, the likelihood of a private medical practitioner, knowingly or recklessly, compromising patient care is not merely implausible—it is antithetical to both professional instinct and institutional self-preservation". 

The court thus observed that it is "inconceivable" that a licensed and qualified medical professional, having undergone rigorous academic training and extensive clinical exposure over several years, would "intentionally" pursue a line of treatment with the objective of "endangering human life".

Doctor took decision in real time without any criminal intent

With respect to the case at hand the court perused the record and said that it unequivocally reflected that the concerned attending physician, confronted with a critical and dynamically evolving clinical scenario, exercised his judgment in "real time, acting with the singular intent to preserve and restore the patient's health".

"The actions undertaken were rooted in his medical wisdom and situational appraisal, not in any form of disregard for the patient's well-being. Whether the chosen course of treatment ultimately succeeded or failed pertains to the unpredictability inherent in medical science and the complexity of human physiology—not to any criminal malintent. Medical decisions taken within the four walls of an operation theatre are often made under acute pressure, with constrained time and information, and under conditions where immediate response is paramount. It is imperative to recognize that the treating doctor, positioned bedside and bearing direct responsibility, exercises clinical discretion shaped by years of training, personal experience, and the unique circumstances presented by the patient at that precise moment".

It said that the retrospective assertion that “another action should have been taken,” or that “a different decision might have yielded a better result,” is a manifestation of hindsight bias, and is not a valid metric for assessing professional culpability.

"In medical jurisprudence, it is inappropriate—indeed, legally impermissible—to superimpose an idealized course of action derived from post-facto analysis over the real-time decisions made in emergent and lifethreatening situations.The clinical process, particularly in emergency operative settings, is governed not by hypothetical perfection but by a constrained equilibrium of risk and benefit, filtered through the doctor's best judgment at the time. The standard is not omniscience but reasonableness. It is a fallacy to presume that because an alternate method appears preferable in the calm of retrospect, the course actually followed was negligent or reckless," the court added.

Background

The complainant alleged that his daughter-in-law was assured of the simplicity of the procedure, and shortly after admission, without comprehensive diagnostic work-up or pre-operative preparedness, she was rushed into surgery involving "hysteroscopy, laparoscopy, and trans-cervical resection of myoma". The complainant contended that essential pre-surgical protocols, including the INR (International Normalized Ratio) test, were not conducted. Post-operatively, the patient's condition reportedly deteriorated rapidly, with persistent unconsciousness, yet she was transferred to a general ward without requisite neurological assessment or CT brain imaging.

The father-in-law alleged that despite signs of severe hemorrhage and administration of multiple blood transfusions, the hospital continued to misrepresent her clinical condition as stable. On 07.09.2024, when her condition worsened further, she was referred to Marengo CIMS Hospital, Ahmedabad. There, the deceased was immediately diagnosed with critical intracranial hemorrhage confirmed–via CT scan–and opined that prior failure to undertake such imaging and timely intervention constituted a breach of medical protocol. A report by a committee constituted under the District Collector's order revealed stark inconsistencies between the hospital's version and that of the patient's attendants. 

Further, the complainant asserted that the hospital's director, later attributed the deceased's health deterioration to a congenital AVM (arteriovenous malformation) and a brain tumour. However, imaging conducted at CIMS Hospital (Ahmedabad) reportedly refuted the presence of any such conditions. The deceased eventually died on 18.9.2024.

Findings

The Court took expert opinions of a State-Level Medical Expert Committee as well as a District-Level Medical Expert Committee, both of which concluded that there was no prima facie evidence of medical negligence. It thus said:

"It is a trite proposition that when a duly constituted medical board comprising domain experts has opined against the existence of negligence, and when no contra expert opinion has been produced to establish a reckless or impermissible departure from the standard of care, criminal prosecution under Section 105 BNS cannot be sustained. The law requires that for an act to constitute criminal medical negligence, it must transcend mere error of judgment and amount to a gross dereliction of duty, evidencing either mens rea or an utter disregard for patient safety—a threshold not satisfied in the instant case". 

The Court held that mere dissatisfaction with the result of the medical treatment could not in itself be a ground for criminal prosecution unless supported by cogent evidence reflecting gross recklessness or culpable negligence.

Further, on the complainant's allegation of deliberate suppression of diagnostics or intentional withholding of information by the petitioners, the Court held that,

“it is wholly unreasonable to expect that minute-to-minute details of the ongoing medical procedures or evolving diagnostic considerations would be exhaustively shared with the patient's attendants, particularly in a high-pressure post-operative setting. Diagnostics reports…are part of the internal clinical deliberations and are generally accessible through proper channels; their non-disclosure to laypersons in real time does not, in and of itself, imply suppression or malafide intent.”

Finally the Court acknowledged the sorrow owing to demise of a family member, however, it was held that it was solemn obligation of the legal system to distinguish between misfortune and culpability, and to ensure that human suffering did not substitute proof required under law.

Accordingly, in light of the expert reports, and the fact that the material failed to establish even a prima facie case of gross medical negligence, the court quashed the FIR.

Case Title: Vinod Shaily & Anr. v State of Rajasthan & Anr, and other connected matters

Citation: 2025 LiveLaw (Raj) 165

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