The Supreme Court has quashed criminal proceedings against an anaesthetist accused of medical negligence in the death of a patient following piles surgery at a Kannur hospital.
A Bench comprising Justice Pankaj Mithal and Justice Prasanna B. Varale delivered the judgment on May 25, 2026. The Court held that the available material did not establish the level of “gross negligence” required for prosecution under Section 304-A IPC.
Background of the Case
The case arose from the death of K.P. Muralidhar. He was admitted to Dhanalakshmi Hospital, Kannur, on May 28, 2002, for piles surgery scheduled the following day.
Dr. Supriya Kumari M.C., the appellant, served as a senior anaesthetist at the hospital.
The prosecution alleged that the patient experienced severe pain after surgery. It claimed that Dr. Kumari instructed nurse Rosamma Varghese to administer sensorcaine injections.
The patient later collapsed and died on May 30, 2002.
A post-mortem examination revealed an 80% blockage in the left coronary artery. Doctors recorded the cause of death as acute coronary insufficiency.
Police initially registered an FIR against the surgeon alone. Later charge sheets named the surgeon, the anaesthetist, and the nurse as accused.
The Magistrate rejected the appellant’s discharge application. The revisional court upheld that decision. The Kerala High Court also refused to quash the proceedings.
Appellant’s Arguments Before the Supreme Court
Senior Advocate R. Basant argued that the prosecution relied on contradictory statements made by the nurse.
In her earlier statements, the nurse said that the surgeon instructed her to administer the injection. Later, she claimed that the appellant had given the instruction.
The appellant argued that even a telephonic instruction would not amount to criminal negligence under Section 304-A IPC.
She relied on the Supreme Court’s decision in Jacob Mathew v State of Punjab. That judgment requires proof of gross negligence before criminal liability can arise against a medical professional.
The appellant also pointed out that her duty ended at 5 p.m. She had left the hospital after ensuring the patient was stable.
According to her, any error occurred during the administration of the medicine by the nurse.
The appellant further relied on consumer forum proceedings. The District Consumer Disputes Redressal Forum did not hold her liable for the patient’s death.
State’s Stand
The State argued that inquiry reports and expert findings established negligence on the appellant’s part.
According to the State, the sensorcaine injections failed to reach the epidural space. This failure allegedly caused severe pain and triggered acute coronary insufficiency.
The State also relied on the expert panel’s opinion. The panel concluded that proper supervision could have prevented the patient’s death.
Supreme Court’s Analysis
The Supreme Court found merit in the appellant’s submissions.
The Bench noted significant contradictions in the nurse’s statements. It held that these inconsistencies weakened the prosecution’s case.
The Court also observed that the appellant had completed her shift before the emergency occurred.
Other doctors, including an on-duty anaesthesiologist, were present at the hospital at the relevant time.
The Bench held that advising a standard analgesic over the phone did not amount to criminal negligence.
The Court observed:
“Any mishap occurred purely in the mechanical execution by the nurse allegedly failing to inject it properly into the epidural space which was entirely beyond the physical control of the off-duty appellant.”
Consumer Forum Findings Favoured the Doctor
The Supreme Court gave considerable weight to the findings of the consumer forum.
The forum had specifically held that the appellant did not instruct the nurse to administer the injection.
Relying on earlier precedents, the Court held that criminal prosecution should not continue when adjudicatory proceedings have already exonerated an accused on merits.
Defect in Expert Panel Composition
The Court also examined the composition of the expert panel.
The four-member panel did not include an anaesthetist.
The Bench held that a panel without a peer specialist could not properly evaluate technical issues relating to epidural anaesthesia.
According to the Court, reliance on such a report failed to satisfy the safeguards laid down in Jacob Mathew.
Criminal Proceedings Quashed
The Court reiterated that criminal liability under Section 304-A IPC requires a direct and proximate connection between the alleged negligent act and the death.
The deceased had a pre-existing coronary blockage. The immediate cause of death was acute coronary insufficiency.
The Bench held that the available material did not establish gross negligence on the appellant’s part.
Accordingly, the Court allowed the appeal. It set aside the Kerala High Court’s order and quashed the criminal proceedings pending against Dr. Supriya Kumari M.C.
