Medical Negligence Investigation Process in India

Posted on 15 Nov at 7:02 am

Medical Negligence Investigation Process in India

Introduction

Medical professionals in India operate under strict ethical and professional standards. While most practice with diligence and integrity, instances of negligence, misconduct, or malpractice do occur. To ensure accountability—without discouraging the autonomy of the medical profession—the Indian legal system has developed a multi-layered framework to evaluate and act upon allegations against doctors.

Table of Contents

Doctors hold a vital position in society, tasked with saving lives and alleviating suffering. Because of this responsibility, the law ensures that healthcare professionals remain answerable when lapses in care, mistakes, or unethical behaviour cause harm to patients.

Medical negligence and malpractice, though often used interchangeably, differ in degree and intent.

Medical Negligence refers to unintentional errors in judgment, skill, or care that result in harm.
Medical Malpractice involves gross incompetence, recklessness, or intentional wrongdoing that significantly deviates from accepted medical standards.

Depending on the severity of the misconduct, consequences may include civil liability, disciplinary action, or criminal prosecution.

Legal Framework Governing Medical Negligence in India

India’s medical accountability system is rooted in multiple laws and regulations:

Indian Penal Code (IPC), 1860 now Repealed by BNS

Addresses criminal negligence, causing death or injury due to reckless acts.

Consumer Protection Act, 2019

Allows patients to seek compensation for deficient medical services.

Civil Laws (Tort Law)

Enables victims to file civil suits for damages.

Ethical Regulations

The Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations govern ethical practice.
After enactment of the National Medical Commission Act, 2019, responsibility for medical ethics shifted to the National Medical Commission (NMC), particularly through the Ethics and Medical Registration Board (EMRB).

Filing a Complaint and Modes of Redressal

An investigation usually begins when a complaint is filed by the aggrieved patient, their family, the hospital, a colleague, or a whistleblower. Complaints can be made before:

Available Forums

Internal Hospital Grievance Mechanisms
State Medical Council or NMC (for professional misconduct)
Consumer Disputes Redressal Commissions (for compensation)
Civil Courts (for tortious claims)
Police/Criminal Courts (for alleged criminal negligence)

Common Allegations

Incorrect diagnosis or delayed treatment
Surgical errors (e.g., leaving instruments inside the body)
Medication errors or wrong dosage
Lack of informed consent
Breach of confidentiality
Gross negligence or misconduct

A valid complaint should include medical records, prescriptions, diagnostic reports, hospital discharge summaries, and details of the alleged negligent act.

Caution in Criminal Complaints

As per Supreme Court guidelines, criminal prosecution should begin only after obtaining an independent medical expert opinion to confirm prima facie negligence. This prevents harassment of doctors for mere complications or treatment failure.

Investigation of the Act

Once expert opinion supports the allegation, an FIR may be registered. The police then collect further evidence such as:

Witness statements
Medical records
Hospital policies
Communication between patient and doctor
Additional expert opinions

Doctors are not normally arrested unless there is a risk of tampering with evidence or influencing witnesses.

Internal Hospital Inquiry

Hospital committees often conduct parallel internal investigations. These typically involve:

Reviewing records and OT logs
Interviewing medical staff
Consulting independent experts
Checking adherence to standard operating procedures

The committee’s findings help the hospital take administrative action, such as warnings, retraining, suspension, or reporting the matter to the State Medical Council or NMC.

Investigation by the State Medical Council or NMC

The State Medical Council or the EMRB under the NMC handles cases of alleged professional misconduct. Their process includes:

Preliminary scrutiny of the complaint
Issuing notice to the doctor for a written defense
Conducting hearings for both parties
Seeking expert medical board reviews
Determining whether ethical or professional standards were violated

Sanctions may include warning, censure, temporary suspension, or permanent cancellation of the medical license. Appeals may be made to the NMC’s appellate board.

Consumer Dispute Redressal and Civil Litigation

Patients seeking compensation often approach Consumer Commissions. The forum depends on the monetary value of the claim:

District Commission – Up to ₹50 lakh
State Commission – ₹50 lakh to ₹2 crore
National Commission – Above ₹2 crore

The court examines whether:

A doctor–patient relationship existed
Duty of care was breached
That breach directly caused harm

Damages may include medical expenses, loss of income, pain and suffering, and rehabilitation costs.

In obvious and egregious cases—such as leaving an instrument inside a patient—the principle of res ipsa loquitur (“the thing speaks for itself”) may apply.

Criminal Liability

Criminal Liability (Updated from IPC to BNS)

With the introduction of the Bharatiya Nyaya Sanhita, 2023 (BNS), several provisions governing criminal negligence have been reorganized and renumbered. Medical negligence that results in harm or death is now evaluated under the relevant BNS sections, which replace parallel provisions under the IPC.

Key BNS Provisions Relevant to Medical Negligence

Section 106 – Causing Death by Negligence
Replaces IPC Section 304A. Applies when a patient’s death is caused by rash or negligent acts of a medical practitioner.
Section 113 – Causing Hurt by Rash or Negligent Act
Replaces IPC Section 337.
Section 115 – Causing Grievous Hurt by Rash or Negligent Act
Replaces IPC Section 338.

These provisions maintain the same legal principles as under the IPC but are structured within the updated BNS framework.

Arrest and Criminal Procedure Under BNS

Courts continue to follow the Supreme Court mandate that:

Doctors should not be arrested routinely, and
Police must secure an independent medical expert opinion before any criminal action.

Criminal liability applies only when negligence is gross, reckless, and far beyond ordinary medical error.

Why This Update Matters

Legal complaints and FIRs filed after the enforcement of BNS must reference BNS sections, not IPC sections. Civil and consumer remedies remain unchanged.

Judicial Tests in Criminal Negligence

Courts distinguish between:

Simple negligence (not criminal)
Gross negligence (may lead to criminal liability)

Judges avoid substituting medical judgment unless negligence is obvious and severe.

Role of Medical Boards

Medical Boards composed of senior, unbiased doctors are often constituted by courts or police to:

Examine treatment records
Compare medical actions with standard protocols
Provide an expert opinion on causation and breach

Their findings significantly influence both civil and criminal outcomes.

Appeal and Review Mechanisms

Doctors have the right to appeal:

State Medical Council decisions before the NMC Appellate Board
Consumer court judgments to higher commissions or the Supreme Court
Criminal decisions through appeals or revisions under procedural laws

Role of the National Medical Commission

The NMC plays a central role in maintaining medical standards through:

Oversight of medical education
Enforcement of ethical codes
Handling complaints
Issuing corrective or punitive actions

Challenges include delayed investigations, shortage of expert witnesses, poor hospital record-keeping, and increasing instances of frivolous complaints that promote defensive medicine.

Judicial Scrutiny

Courts consistently emphasize:

Protection of ethical practitioners
Prevention of misuse of criminal law
Reliance on unbiased medical expert opinions
The need for thorough documentation and informed consent

Landmark judgments have shaped standards of proof, duty of care, compensation, and when res ipsa loquitur applies.

Conclusion

Investigating medical negligence in India involves a multi-stage process that includes police inquiry, medical expert review, professional oversight, and judicial examination. The goal is not to punish doctors for every adverse medical outcome, but to hold them accountable when they violate their duty of care.

A balanced legal system must protect patient rights while upholding the dignity and autonomy of medical practitioners. Strengthening documentation, improving medical ethics compliance, and establishing specialized tribunals can further enhance transparency, timely justice, and public trust in healthcare.

Frequently Asked Questions (FAQs)

1. What qualifies as medical negligence in India?

Medical negligence occurs when a doctor fails to provide reasonable care expected of a competent practitioner, causing harm to the patient.

2. Can a patient file a complaint directly with the NMC?

No, complaints must first be filed with the State Medical Council. Appeals can then be made to the NMC.

3. Is expert opinion mandatory in medical negligence cases?

Yes. Courts and police require an independent expert opinion before proceeding, especially in criminal matters.

4. What remedies are available to patients?

Patients can seek compensation, disciplinary action against the doctor, or criminal proceedings depending on the severity.

5. Can failure of treatment alone be considered negligence?

No. A bad outcome or complication is not negligence unless there is clear deviation from standard medical practice.

6. How long does a medical negligence case take?

Timelines vary, but cases in consumer courts generally take 1–3 years depending on complexity and evidence.

7. Are hospitals also liable for negligence?

Yes. Hospitals may be vicariously liable for acts of employed doctors or staff.

8. Can doctors be arrested for medical negligence?

Arrest is rare and occurs only in cases of gross negligence or risk of evidence tampering.

9. Is informed consent legally required?

Yes. Lack of proper informed consent may amount to both ethical violation and negligence.

10. What compensation can a patient receive?

Compensation may cover medical expenses, loss of income, pain and suffering, and long-term rehabilitation.

Incase, You wish to discuss, and talk on any such matter that, ‘You may need help with’. Feel free to contact us. Our team at www.legalwellbeing.in shall be happy to assist.

Written by Team Member(s) and Ms. Aparna Mishra.

Source And References

National Medical Commission Act, 2019.
Consumer Protection Act, 2019.
A.P. Singh, Consumer Protection and Medical Negligence in India: A Legal Perspective, (2021) 5(1) Indian Journal of Legal Studies 93.
Ethics and Medical Registration Board, National Medical Commission, Code of Medical Ethics, https://www.nmc.org.in
Jacob Mathew v. State of Punjab, (2005) 6 SCC 1.
Spring Meadows Hospital v. Harjot Ahluwalia, (1998) 4 SCC 39.
Dr. Laxman Balakrishna Joshi v. Dr. Trimbak Bapu Godbole, AIR 1969 SC 128.
V. Balachandran, Medical Negligence: Law & Interpretation (LexisNexis 2020).
K.K. Saini, Criminal Liability of Doctors for Medical Negligence, (2015) 57(2) Journal of the Indian Law Institute 17.
B.K. Sharma, Medical Negligence and Compensation, (4th edn., Universal Law Publishing 2022).
J. Pandey, Professional Ethics and Disciplinary Actions against Doctors, (2023) 3(1) Indian Bar Review 112.
Kusum Sharma v. Batra Hospital and Medical Research Centre, (2010) 3 SCC 480.
V. Kishan Rao v. Nikhil Super Speciality Hospital, (2010) 5 SCC 513.
Anuradha Saha v. AMRI Hospital, (2014) 1 SCC 384.
Malay Kumar Ganguly v. Sukumar Mukherjee, (2009) 9 SCC 221.
P. Mehrotra, Role of Expert Evidence in Medical Negligence Cases, (2022) 8(2) Delhi Law Review 55.