Introduction:
In the case titled Vinod Shaily & Anr. v. State of Rajasthan & Anr. Along with other connected matters, the Rajasthan High Court, through Justice Farjand Ali, rendered a significant judgment concerning criminal allegations against medical professionals. The FIR under challenge had been filed under Section 105 of the Bharatiya Nyaya Sanhita (BNS), which deals with culpable homicide not amounting to murder. The complainant, aggrieved by the death of his daughter-in-law following a minor surgical procedure at a private hospital in Jodhpur, accused four doctors of grave medical negligence. Allegations included omission of essential pre-operative diagnostic protocols, delayed diagnostics, improper post-operative care, and failure to recognise and manage critical complications promptly. In its comprehensive decision, the Court not only scrutinised the medical facts of the case but also made broader jurisprudential observations about the intrinsic deterrents against willful medical negligence in private healthcare practice.
Arguments of Both Sides:
The complainant, Vinod Shaily, alleged that his daughter-in-law was admitted to the hospital under the assurance that the surgical procedure, targeting a minor uterine fibroid, was simple and low-risk. However, according to him, the hospital and its staff failed to undertake a comprehensive diagnostic work-up before the procedure. Specifically, the INR (International Normalised Ratio) test, which is critical to ascertain the blood’s clotting ability, was allegedly not conducted. He asserted that the patient was rushed into surgery involving hysteroscopy, laparoscopy, and trans-cervical resection of myoma without adequate pre-operative preparedness. Post-operatively, her condition reportedly deteriorated rapidly; despite persistent unconsciousness, the patient was moved to a general ward without conducting a CT brain scan or undertaking proper neurological evaluations. The complainant contended that even as signs of internal haemorrhage became apparent, requiring multiple transfusions, s—the hospital continued to assure the family that the patient’s condition was stable. On September 7, 2024, her condition worsened drastically, and she was referred to Marengo CIMS Hospital in Ahmedabad, where a CT scan immediately revealed a severe intracranial haemorrhage. The complainant alleged that had such imaging been done earlier, appropriate interventions could have saved her life. A district-level medical inquiry, he said, revealed inconsistencies between the hospital’s account and the patient’s family’s version. Furthermore, he alleged a cover-up, pointing out that the hospital’s director attributed her death to congenital Arteriovenous Malformation (AVM) and a brain tumour, both of which were reportedly not corroborated by imaging conducted at CIMS Hospital. He requested that the FIR lodged under Section 105 BNS be allowed to continue, citing loss of life due to medical negligence.
On the contrary, the accused doctors argued that the FIR was a result of hindsight bias and emotional reaction, rather than legal or clinical reasoning. They maintained that all decisions taken during treatment were made in real-time under stressful and dynamic conditions. The attending physician exercised clinical discretion based on years of training, and his actions were aimed at preserving life rather than risking it. The doctors emphasised the complex and unpredictable nature of medical science, arguing that an adverse outcome alone does not constitute criminal negligence. They pointed to the absence of pre-existing medical conditions, particularly the lack of AVM or brain tumour in imaging reports, as evidence of the natural unpredictability of human physiology rather than malfeasance. Importantly, the defence cited expert reports from both State-Level and District-Level Medical Expert Committees, which found no prima facie case of medical negligence. They contended that, in the absence of gross recklessness, mens rea, or utter disregard for patient safety, the invocation of criminal charges under Section 105 BNS was both unwarranted and damaging to the reputation and practice of the doctors involved.
Court’s Judgement:
The Rajasthan High Court, after meticulously reviewing the material on record and the arguments of both parties, quashed the FIR against the doctors. Justice Farjand Ali authored a detailed judgment that went beyond the specifics of the case to comment on the broader legal and ethical framework governing private healthcare. The Court first noted that it was inconceivable for a licensed, qualified, and institutionally affiliated medical professional to intentionally endanger human life. Such conduct, it stated, would be antithetical not only to professional training and ethics but also to the logic of institutional survival in the private healthcare sector. The judgment emphasised that private medical institutions thrive on goodwill, public trust, and reputational integrity. Any willful lapse in patient care risks triggering a cascade of consequences—professional ruin, financial instability, and even institutional collapse. Hence, the Court opined, these natural deterrents significantly reduce the likelihood of intentional medical negligence.
Justice Ali elaborated on the nature of decision-making in the medical profession. The Court acknowledged that clinical decisions are made under immense pressure, especially in emergency and post-operative settings. Medical professionals, the Court said, exercise their best judgment at a given moment, based on limited time and incomplete data. Retrospective criticism of these decisions, particularly by those without medical training, often falls into the trap of hindsight bias. The Court rejected such backwards-looking evaluations as flawed and legally impermissible in determining criminal culpability. It emphasised that the legal standard in cases of alleged medical negligence is not one of perfection but of reasonableness.
Critically, the Court gave substantial weight to the findings of the State-Level and District-Level Medical Expert Committees, both of which found no evidence of gross negligence. The law, as clarified by the Court, requires that for criminal prosecution to be sustained under Section 105 BNS, the act in question must surpass mere error of judgment and qualify as a gross dereliction of duty marked by either criminal intent (mens rea) or a willful disregard for patient safety. The threshold, according to the Court, was not met in the present case. In doing so, it reiterated a well-established legal principle: mere dissatisfaction with the result of medical treatment cannot, by itself, justify criminal prosecution.
The Court also addressed the complainant’s claim regarding the suppression of diagnostic reports and withholding of information. It found such allegations unsubstantiated, holding that in high-pressure medical environments, it is neither feasible nor legally required for doctors to share real-time, minute-to-minute clinical updates with patient attendants. Diagnostic reports, it explained, are part of internal clinical deliberations and can be accessed through formal mechanisms. Their non-disclosure does not automatically imply malafide intent or suppression.
Finally, the Court acknowledged the profound grief and sorrow experienced by the complainant due to the loss of a family member. However, it emphasised the solemn obligation of the judiciary to distinguish between human tragedy and legal culpability. Emotional distress, however genuine, cannot substitute the evidentiary standards mandated by law. The role of the court, it held, was to ensure that justice was based on legal principles, not emotional appeals. Therefore, finding no merit in the allegations and noting the expert opinions, the Court quashed the FIR and exonerated the accused doctors from the criminal proceedings.