Medical Negligence | 'Commission Under WB Clinical Establishments Act Can Decide Deficiency In Patient Service': Supreme Court

The Supreme Court recently held that the Commission established under West Bengal Clinical Establishments Act, 2017 is entitled to adjudicate upon 'deficiency in patient care service' as well as to award compensation.

"Section 38 categorically provides that medical negligence complaints would be dealt with by the State Medical Councils. The Division Bench held that the Commission was not entitled to give any finding in this regard. The Commission in its judgment expressly states that they are not entering into the question of negligence. We find that the Commission indeed had not. What it had done was consider a complaint of deficiency in patient care service and in order to ascertain whether there was a deficiency or not looked into the credentials of persons providing the service. The same is expressly permitted by this Section."

A bench of Justices Sanjay Karol and Manoj Misra rejected the contention that the issues of 'medical negligence' and 'deficiency in patient care service' are so inextricably intertwined that the Commission cannot adjudicate upon 'deficiency in service' and only the State Medical Council can return a finding on 'negligence'.

It observed that Section 36 of the WBCE Act, which provides for establishment of the Commission, contains the phrase 'supervision' and 'supervision' would necessarily include ensuring that all personnel within a clinical establishment are entitled by way of their education and certification to be employed there.

The Court was dealing with the case of one Kousik Pal, whose mother was admitted in the respondent-hospital for 5 days. On advice of the primary consultant, the petitioner's mother was referred to another hospital. Her discharge summary, prepared by another doctor, recorded that she was 'stable'. But within hours of the transfer, the petitioner's mother passed away. Thereafter, the petitioner filed a complaint against the respondent-hospital, alleging negligence and improper diagnosis.

In 2018, the Commission established under WBCE Act held that the description of the condition of petitioner's mother as 'stable' was erroneous. It further found two doctors at the hospital (concerned with the petitioner's mother) unqualified to hold the positions that they did, ie Head, Non-Invasive Department and ECG Technician, and that the medical courses they pursued were not recognized with the concerned Medical Council. This was held to be a deficiency in patient care service and unethical trade practice. The Commission directed payment of compensation of Rs.20 lakhs.

The Commission also took note of the conduct of the doctor who declared the petitioner's mother 'stable' for transfer, but did not go into the issue of medical negligence (being in purview of WBMC).

In appeal by the respondent-hospital, a Single Judge of the High Court upheld the Commission's findings and held that it had the jurisdiction to go into the question of educational qualifications of the doctors employed by the hospital. Later, a Division Bench overturned the findings of the Commission and the Single Judge, holding that the material did not indicate a connection between the hospital's conduct and the death of the petitioner's mother.

The Division Bench also observed that disciplinary action against physician claiming to be a specialist can be taken only by the West Bengal Medical Council and the Commission could not have held that the doctors were not qualified to take the actions they did. It was further held that medical negligence and patient care are “so inextricably mingled up” that they cannot be separated and since the issue of negligence can only be taken up by a specialized body, the Commission could not have adjudicated this issue.

Aggrieved, the petitioner approached the Supreme Court.

On hearing the parties and perusing the material, the top Court disagreed with the Division Bench's view. "In the instant case, the words described above would indicate that the Commission in its jurisdiction would have the power to ensure that the personnel employed by clinical establishments are in accordance with the requirements laid down, thereby, complying with the benchmark" it noted.

It further observed that, "Making a simple statement that the mother of the appellant had erroneously been described as 'stable' cannot and should not absolve the concerned doctor of responsibility".

The Court also noted that as per Section 38(1)(x) of the WBCE Act, it is the function of the Commission to ensure that persons hired are duly qualified. Therefore, the Commission giving a finding on qualification of these two persons, is in accordance with the law. The Court also observed from the penalties contemplated under the Act that the intention of the legislature behind its enactment was that the patient be zealously safeguarded.

Setting aside the judgment of the Division Bench and restoring that of the Commission, the top Court held,

"The High Court gave too wide a berth to the State Medical Council leaving almost no room for the Commission to function. The power to grant compensation as is given under this Act, is separate and distinct from the power of the State Medical Council to examine the presence or absence of medical negligence on the part of a professional, and it nowhere interferes with the power of the State Medical Council to adjudicate the complaints of medical negligence. If the findings of the Division Bench are accepted that deficiency in patient care service and medical negligence, in certain cases, are so enmeshed in one another that they cannot be separated, in quite a few cases the functionality of the Commission would be rendered impossible defeating the legislative intent behind this Act."

Case Title: KOUSIK PAL VERSUS B.M. BIRLA HEART RESEARCH CENTRE & ORS., SLP(C)No.8365/2024

Citation : 2025 LiveLaw (SC) 1248

Click here to read judgment